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1. Association of preoperative beta-blocker use and cardiac complications after major noncardiac surgery: a prospective cohort study

Author

Mueller, Philip, Burri, Katrin, Weder, Samantha, Skolozubova, Daria, Horvat-Csoti, Sonja, Doebele, Niklas, Schaer, Marco, Heimbach, Bent, Lopez-Ayala, Pedro, Seeberger, Esther, Doyle, Nadine, Meissner, Kathrin, Glarner, Noemi, Puelacher, Christian, Gualandro, Danielle M., Pargger, Mirjam, Huré, Gabrielle, Maiorano, Silvia, Strebel, Ivo, Fried, Simona, Bolliger, Daniel, Steiner, Luzius A., Lampart, Andreas, Lurati Buse, Giovanna, Mujagic, Edin, Lardinois, Didier, Kindler, Christoph, Guerke, Lorenz, Schaeren, Stefan, Mueller, Andreas, Clauss, Martin, Buser, Andreas, Hammerer-Lercher, Angelika, and Mueller, Christian

Published
2024
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3. Association of preoperative beta-blocker use and cardiac complications after major noncardiac surgery: a prospective cohort study

Author

Glarner, Noemi, primary, Puelacher, Christian, additional, Gualandro, Danielle M., additional, Pargger, Mirjam, additional, Huré, Gabrielle, additional, Maiorano, Silvia, additional, Strebel, Ivo, additional, Fried, Simona, additional, Bolliger, Daniel, additional, Steiner, Luzius A., additional, Lampart, Andreas, additional, Lurati Buse, Giovanna, additional, Mujagic, Edin, additional, Lardinois, Didier, additional, Kindler, Christoph, additional, Guerke, Lorenz, additional, Schaeren, Stefan, additional, Mueller, Andreas, additional, Clauss, Martin, additional, Buser, Andreas, additional, Hammerer-Lercher, Angelika, additional, Mueller, Christian, additional, Mueller, Philip, additional, Burri, Katrin, additional, Weder, Samantha, additional, Skolozubova, Daria, additional, Horvat-Csoti, Sonja, additional, Doebele, Niklas, additional, Schaer, Marco, additional, Heimbach, Bent, additional, Lopez-Ayala, Pedro, additional, Seeberger, Esther, additional, Doyle, Nadine, additional, and Meissner, Kathrin, additional

Published
2024
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4. Comparison of fourteen rule-out strategies for acute myocardial infarction

Author

Mueller, Deborah, Sazgary, Lorraine, Marbot, Stella, Sabti, Zaid, Flores, Dayana, Meissner, Kathrin, Kulangara, Caroline, Freese, Michael, Osswald, Stefan, Stelzig, Claudia, Bingisser, Roland, López, Beatriz, Agüero, María Martínez, Nowalany-Kozielska, Ewa, Kawecki, Damian, Parenica, Jiri, Ganovská, Eva, Lohrmann, Jens, Buser, Andreas, Grimm, Karin, Hartmann, Beate, Muzyk, Piotr, Rentsch, Katharina, von Eckardstein, Arnold, Wildi, Karin, Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Badertscher, Patrick, Wussler, Desiree, Giménez, Maria Rubini, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Dietsche, Sebastian, Walter, Joan, Kozhuharov, Nikola, Morawiec, Beata, Miró, Òscar, Javier Martin-Sanchez, F., Subramaniam, Sinthuri, Geigy, Nicolas, Keller, Dagmar I., Reichlin, Tobias, and Mueller, Christian

Published
2019
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5. Prospective validation of prognostic and diagnostic syncope scores in the emergency department

Author

du Fay de Lavallaz, Jeanne, Badertscher, Patrick, Nestelberger, Thomas, Isenrich, Rahel, Miró, Òscar, Salgado, Emilio, Geigy, Nicolas, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Bustamante Mandrión, José, Di Somma, Salvatore, Peacock, W. Frank, Kawecki, Damian, Boeddinghaus, Jasper, Twerenbold, Raphael, Puelacher, Christian, Wussler, Desiree, Strebel, Ivo, Keller, Dagmar I., Poepping, Imke, Kühne, Michael, Mueller, Christian, Reichlin, Tobias, Giménez, Maria Rubini, Walter, Joan, Kozhuharov, Nikola, Shrestha, Samyut, Mueller, Deborah, Sazgary, Lorraine, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Freese, Michael, Stelzig, Claudia, Meissner, Kathrin, Kulangara, Caroline, Hartmann, Beate, Ferel, Ina, Sabti, Zaid, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, von Eckardstein, Arnold, Buser, Andreas, Kloos, Wanda, Lohrmann, Jens, and Osswald, Stefan

Published
2018
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6. Jenseits der Utopie? Zur visuellen Konstruktion städtischer Beteiligungsverfahren am Beispiel des Dragonerareals in Berlin-Kreuzberg

Author

Singh, Ajit Jacob, Meißner, Kathrin, Singh, Ajit Jacob, and Meißner, Kathrin

Abstract

Der Beitrag erweitert die bisherigen Untersuchungen von Visualisierungen städtischer Wirklichkeiten um die qualitative Analyse visueller Praktiken und Visualisierungskulturen im Kontext stadtplanerischer Beteiligungsverfahren. Am empirischen Fall des Modellprojekts Rathausblock in Berlin-Kreuzberg zeigen wir auf, wie die zu beplanenden Räume und das Verfahren durch die Planungsbeteiligten visualisiert und als umkämpfter und auszuhandelnder Raum sichtbar gemacht werden. Rekonstruiert wird anhand von vier typisch wiederkehrenden Visualisierungsformen (Plänen, Logos, Fotografien und computergestützten Architekturdarstellungen), wie die beteiligten Akteure ihre Positionen, Ziele, Utopien sowie ihr Wissen wirkmächtig und öffentlich kommunizieren. Visualisierungen werden dabei als Produkte sinnhafter menschlicher Imaginationen behandelt, durch die Akteure ihre Welt für sich selbst und für andere versteh- und erfahrbar machen wollen. Im Beitrag wird infolgedessen einerseits die besondere Relevanz der visuellen und symbolischen Konstruktion des Ortes und des Verfahrens durch die beteiligten Akteure herausgearbeitet. Andererseits wird betont, dass die Visualisierungen zumeist die Handlungsprobleme der Beteiligten invisibilisieren und damit eine kritische Analyse auch das zum Gegenstand hat, was nicht gezeigt wird., The article expands previous studies of visualisations of urban realities, by examining the visual practices and the meaning of visual representations of participation processes in urban planning. Based on the empirical case of the „Model Project Rathausblock“, in particular the „Dragonerareal“ in Berlin-Kreuzberg, we show how the spaces being planned and the planning procedure are visualised from the perspective of the different participating actors and how the planned area is visually constructed as a contested and negotiated space. By identifying four typically recurring forms of visualisations (plans, logos, photographs and computer-aided architectural representations), we reconstruct how the involved actors shape their positions, goals, utopias and knowledge through powerful visual (and digital) communication. In this context, we consider visualisations as a product of meaningful imagination and communication, through which actors try to make their world understandable and experienceable for themselves and for others. Consequently, the paper elaborates on the one hand the particular relevance of the visual and symbolic construction of the place and the participatory process. On the other hand, we emphasize that the visualisations partly invisibilise the action problems of the participating actors and that a critical analysis from a methodological standpoint should also reflect what is not shown.

Published
2023

7. Direct Comparison of the 0/1h and 0/3h Algorithms for Early Rule-Out of Acute Myocardial Infarction

Author

Badertscher, Patrick, Boeddinghaus, Jasper, Twerenbold, Raphael, Nestelberger, Thomas, Wildi, Karin, Wussler, Desiree, Schwarz, Jonas, Puelacher, Christian, Rubini Giménez, Maria, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Cerminara, Sara Elisa, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Morawiec, Beata, Muzyk, Piotr, Keller, Dagmar I., Reichlin, Tobias, Mueller, Christian, Sabti, Zaid, Strebel, Ivo, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Kulangara, Caroline, Meissner, Kathrin, Schaerli, Nicolas, Mueller, Deborah, Yufera Sanchez, Ana, Sazgary, Lorraine, Marbot, Stella, Fuenzalida, Carolina, Calderón, Sofia, Rodriguez Adrada, Esther, Kawecki, Damian, Nowalany-Kozielska, Ewa, Parenica, Jiri, Ganovská, Eva, von Eckardstein, Arnold, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Buser, Andreas, Bingisser, Roland, and Geigy, Nicolas

Published
2018
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8. Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization

Author

Puelacher, Christian, Lurati Buse, Giovanna, Seeberger, Daniela, Sazgary, Lorraine, Marbot, Stella, Lampart, Andreas, Espinola, Jaqueline, Kindler, Christoph, Hammerer, Angelika, Seeberger, Esther, Strebel, Ivo, Wildi, Karin, Twerenbold, Raphael, du Fay de Lavallaz, Jeanne, Steiner, Luzius, Gurke, Lorenz, Breidthardt, Tobias, Rentsch, Katharina, Buser, Andreas, Gualandro, Danielle M., Osswald, Stefan, Mueller, Christian, Seeberger, Manfred, Christ-Crain, Mirjam, Cuculi, Florim, Badertscher, Patrick, Nestelberger, Thomas, Wussler, Desiree, Flores, Dayana, Boeddinghaus, Jasper, Sabti, Zaid, Giménez, Maria Rubini, Kozhuharov, Nikola, Shrestha, Samyut, Kloos, Wanda, Lohrmann, Jens, Reichlin, Tobias, Freese, Michael, Meissner, Kathrin, Kaiser, Christoph, and Buser, Andreas

Published
2018
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12. Growth differentiation factor-15 and all-cause mortality in patients with suspected myocardial infarction

Author

Giménez, Maria Rubini, Puelacher, Christian, Kozhuharov, Nikola, Morawiec, Beata, Rentsch, Katharina, Miró, Òscar, Martin-Sanchez, F. Javier, Muzyk, Piotr, Geigy, Nicolas, Keller, Dagmar I., Reichlin, Tobias, Lohrmann, Jens, Biskup, Ewalina, Kloos, Wanda, López, Beatriz, Inostroza, Carolina Fuenzalida, Adrada, Esther Rodriguez, Kawecki, Damian, Nowalany-Kozielska, Ewa, Parenica, Jiri, Meissner, Kathrin, Kulangara, Caroline, Mahfouz, Riham, von Eckardstein, Arnold, Walter, Joan, Nestelberger, Thomas, Boeddinghaus, Jasper, Twerenbold, Raphael, Croton, Lukas, Badertscher, Patrick, Wildi, Karin, Wussler, Desiree, du Fay de Lavallaz, Jeanne, and Mueller, Christian

Published
2019
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14. Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I

Author

Boeddinghaus, Jasper, primary, Nestelberger, Thomas, additional, Koechlin, Luca, additional, Wussler, Desiree, additional, Lopez-Ayala, Pedro, additional, Walter, Joan Elias, additional, Troester, Valentina, additional, Ratmann, Paul David, additional, Seidel, Funda, additional, Zimmermann, Tobias, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Rubini Giménez, Maria, additional, Potlukova, Eliska, additional, Strebel, Ivo, additional, Freese, Michael, additional, Miró, Òscar, additional, Martin-Sanchez, F. Javier, additional, Kawecki, Damian, additional, Keller, Dagmar I., additional, Gualandro, Danielle M., additional, Christ, Michael, additional, Twerenbold, Raphael, additional, Mueller, Christian, additional, Meier, Mario, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Kozhuharov, Nikola, additional, Rentsch, Katharina, additional, Stelzig, Claudia, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Hillinger, Petra, additional, Michou, Eleni, additional, Flores, Dayana, additional, Reichlin, Tobias, additional, López, Beatriz, additional, Fuenzalida, Carolina, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Huber, Jeffrey, additional, Steude, Jana, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Nowalany-Kozielska, Ewa, additional, Muzyk, Piotr, additional, Bürgler, Franz, additional, and Geigy, Nicolas, additional

Published
2020
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15. Communicating and Visualising Urban Planning in Cold War Berlin

Author

Bernhardt, Christoph, Meissner, Kathrin, Bernhardt, Christoph, and Meissner, Kathrin

Abstract

This article analyses the dynamics of communication, specifically with regard to the significance of visualisations in urban planning between the two competing political regimes of East and West Germany in divided Berlin (1945-1989). The article will demonstrate the ways in which planners on either side of the Iron Curtain were confronted with matters unique to their own political contexts and conditions for public communication, as well as how they faced similar challenges in fields of urban renewal and negotiating public participation. The post-war decades in Berlin were marked by strong planning dynamics: large-scale reconstruction after WWII and the 'showcase character' of political confrontation and competition. In this context, new strategies of communicating urban planning to the public were developed, such as large-scale development plans, public exhibitions and cross-border media campaigns. Paradigmatic shifts during the mid-1970s generated new discourses about urban renewal and historic preservation. The new focus on small-scale planning in vivid and inhabited inner-city neighbourhoods made new forms of communication and public depiction necessary. In the context of social and political change as well as growing mediatisation, planning authorities utilised aspects of urban identity and civic participation to legitimise planning activities. The article traces two small-scale planning projects for neighbourhoods in East and West Berlin and investigates the interrelation of visual communication instruments in public discourses and planning procedures during the 1980s, a period that prominently featured the new strategy of comprehensive planning. Furthermore, the article highlights the key role of micro-scale changes in the management of urban renewal along both sides of the wall and the emergence of neighbourhood civil engagement and participation.

Published
2020

16. Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and Heart Failure Rehospitalization Among Patients With Acute Heart Failure: The GALACTIC Randomized Clinical Trial

Author

Kozhuharov, Nikola, Goudev, Assen, Flores, Dayana, Maeder, Micha T., Walter, Joan, Shrestha, Samyut, Gualandro, Danielle Menosi, de Oliveira Junior, Mucio Tavares, Sabti, Zaid, Müller, Beat, Noveanu, Markus, Socrates, Thenral, Ziller, Ronny, Bayés-Genís, Antoni, Sionis, Alessandro, Simon, Patrick, Michou, Eleni, Gujer, Samuel, Gori, Tommaso, Wenzel, Philip, Pfister, Otmar, Conen, David, Kapos, Ioannis, Kobza, Richard, Rickli, Hans, Breidthardt, Tobias, Münzel, Thomas, Erne, Paul, Mueller, Christian, Galactic Investigators, Dimov, Bojidar, Hartwiger, Sabine, Arenja, Nisha, Glatz, Bettina, Herr, Natascha, Isenrich, Rahel, Mosimann, Tamina, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Puelacher, Christian, Freese, Michael, Vögele, Janine, Meissner, Kathrin, Martin, Jasmin, Strebel, Ivo, Wussler, Desiree, Schumacher, Carmela, Osswald, Stefan, Vogt, Fabian, Hilti, Jonas, Barata, Sara, Schneider, Deborah, Schwarz, Jonas, Fitze, Brigitte, Rentsch, Katharina, Bossa, Aline, Jallad, Sergio, Soeiro, Alexandre, Georgiev, Dimitar, Jansen, Thomas, Gebel, Gabriele, Bossard, Matthias, and Christ, Michael

Published
2019
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17. Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Greenslade, Jaimi, additional, Parsonage, William A, additional, Than, Martin, additional, Wussler, Desiree, additional, Lopez-Ayala, Pedro, additional, Zimmermann, Tobias, additional, Meier, Mario, additional, Troester, Valentina, additional, Badertscher, Patrick, additional, Koechlin, Luca, additional, Wildi, Karin, additional, Anwar, Mahnoor, additional, Freese, Michael, additional, Keller, Dagmar I, additional, Reichlin, Tobias, additional, Twerenbold, Raphael, additional, Cullen, Louise, additional, Mueller, Christian, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Rubini Giménez, Maria, additional, Strebel, Ivo, additional, Walter, Joan, additional, Huber, Jeffrey, additional, Christ, Michael, additional, Kozhuharov, Nikola, additional, Gualandro, Danielle M, additional, Potlukova, Eliska, additional, Baumgartner, Benjamin, additional, Hafner, Benjamin, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Gil, Beatriz, additional, Martin-Sanchez, F Javier, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, López, Beatriz, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Steude, Jana, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Nowalany-Kozielska, Ewa, additional, and Muzyk, Piotr, additional

Published
2019
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18. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction

Author

Boeddinghaus, Jasper, primary, Twerenbold, Raphael, additional, Nestelberger, Thomas, additional, Koechlin, Luca, additional, Wussler, Desiree, additional, Meier, Mario, additional, Troester, Valentina, additional, Zimmermann, Tobias, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Rubini Giménez, Maria, additional, Lopez-Ayala, Pedro, additional, Potlukova, Eliska, additional, Miró, Òscar, additional, Martin-Sanchez, F Javier, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Keller, Dagmar I, additional, Reichlin, Tobias, additional, Mueller, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Walter, Joan Elias, additional, Freese, Michael, additional, Puelacher, Christian, additional, Hafner, Benjamin, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Rentsch, Katharina, additional, Gualandro, Danielle M, additional, Schaerli, Nicolas, additional, Stelzig, Claudia, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Hillinger, Petra, additional, Grimm, Karin, additional, Michou, Eleni, additional, Flores, Dayana, additional, Czmok, Rafael, additional, Osswald, Stefan, additional, López, Beatriz, additional, Fuenzalida, Carolina, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Christ, Michael, additional, Steude, Jana, additional, Fahrni, Gregor, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Nowalany-Kozielska, Ewa, additional, and Muzyk, Piotr, additional

Published
2019
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19. Growth differentiation factor-15 and all-cause mortality in patients with suspected myocardial infarction

Author

Walter, Joan, primary, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Croton, Lukas, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Wussler, Desiree, additional, du Fay de Lavallaz, Jeanne, additional, Mueller, Christian, additional, Giménez, Maria Rubini, additional, Puelacher, Christian, additional, Kozhuharov, Nikola, additional, Morawiec, Beata, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Martin-Sanchez, F. Javier, additional, Muzyk, Piotr, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Lohrmann, Jens, additional, Biskup, Ewalina, additional, Kloos, Wanda, additional, López, Beatriz, additional, Inostroza, Carolina Fuenzalida, additional, Adrada, Esther Rodriguez, additional, Kawecki, Damian, additional, Nowalany-Kozielska, Ewa, additional, Parenica, Jiri, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Mahfouz, Riham, additional, and von Eckardstein, Arnold, additional

Published
2019
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20. Predicting Major Adverse Events in Patients With Acute Myocardial Infarction

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Wussler, Desiree, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Miró, Òscar, additional, López, Beatriz, additional, Martin-Sanchez, F. Javier, additional, Muzyk, Piotr, additional, Koechlin, Luca, additional, Baumgartner, Benjamin, additional, Meier, Mario, additional, Troester, Valentina, additional, Rubini Giménez, Maria, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Zimmermann, Tobias, additional, Gualandro, Danielle M., additional, Michou, Eleni, additional, Potlukova, Eliska, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Hafner, Benjamin, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Rodríguez Adrada, Esther, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Amrein, Melissa, additional, Steude, Jana, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Morawiec, Beata, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Biskup, Ewalina, additional, Campodarve, Isabel, additional, and Gea, Joachim, additional

Published
2019
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21. Prevalence of Pulmonary Embolism in Patients With Syncope

Author

Badertscher, Patrick, primary, du Fay de Lavallaz, Jeanne, additional, Hammerer-Lercher, Angelika, additional, Nestelberger, Thomas, additional, Zimmermann, Tobias, additional, Geiger, Marc, additional, Imahorn, Orell, additional, Miró, Òscar, additional, Salgado, Emilio, additional, Christ, Michael, additional, Cullen, Louise, additional, Than, Martin, additional, Martin-Sanchez, F. Javier, additional, Di Somma, Salvatore, additional, Peacock, W. Frank, additional, Keller, Dagmar I., additional, Costabel, Juan Pablo, additional, Walter, Joan, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Méndez, Adriana, additional, Gospodinov, Boris, additional, Puelacher, Christian, additional, Wussler, Desiree, additional, Koechlin, Luca, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Strebel, Ivo, additional, Lohrmann, Jens, additional, Kühne, Michael, additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Rubini Giménez, Maria, additional, Kozhuharov, Nikola, additional, Shrestha, Samyut, additional, Sazgary, Lorraine, additional, Morawiec, Beata, additional, Muzyk, Piotr, additional, Nowalany-Kozielska, Ewa, additional, Bustamante Mandrión, José, additional, Poepping, Imke, additional, Freese, Michael, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Greenslade, Jaimi, additional, Hawkins, Tracey, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Buser, Andreas, additional, Kloos, Wanda, additional, Steude, Jana, additional, and Osswald, Stefan, additional

Published
2019
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22. Early Diagnosis of Myocardial Infarction in Patients With a History of Coronary Artery Bypass Grafting

Author

Koechlin, Luca, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Wussler, Desiree, additional, Walter, Joan, additional, Martin-Sanchez, F. Javier, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Twerenbold, Raphael, additional, Mueller, Christian, additional, Reichlin, Tobias, additional, Zimmermann, Tobias, additional, Meier, Mario, additional, Troester, Valentina, additional, Huber, Jeffrey, additional, Christ, Michael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Giménez, Maria Rubini, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Gualandro, Danielle M., additional, Potlukova, Eliska, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Shrestha, Samyut, additional, Kawecki, Damian, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Flores, Dayana, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Kulangara, Caroline, additional, Meissner, Kathrin, additional, Fahrni, Gregor, additional, Michou, Eleni, additional, Osswald, Stefan, additional, Jeger, Raban, additional, Kaiser, Christoph, additional, López, Beatriz, additional, Calderón, Sofia, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Gea, Joachim, additional, Reuthebuch, Oliver, additional, Grapow, Martin, additional, and Eckstein, Friedrich, additional

Published
2019
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23. High-Sensitivity Cardiac Troponin I Assay for Early Diagnosis of Acute Myocardial Infarction

Author

Boeddinghaus, Jasper, primary, Nestelberger, Thomas, primary, Twerenbold, Raphael, primary, Koechlin, Luca, primary, Meier, Mario, primary, Troester, Valentina, primary, Wussler, Desiree, primary, Badertscher, Patrick, primary, Wildi, Karin, primary, Puelacher, Christian, primary, du Fay de Lavallaz, Jeanne, primary, Rubini Giménez, Maria, primary, Zimmermann, Tobias, primary, Hafner, Benjamin, primary, Potlukova, Eliska, primary, Miró, Òscar, primary, Martin-Sanchez, F Javier, primary, Keller, Dagmar I, primary, Reichlin, Tobias, primary, Mueller, Christian, primary, Walter, Joan Elias, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Freese, Michael, additional, Fuenzalida, Carolina, additional, Stelzig, Claudia, additional, Gualandro, Danielle M, additional, Michou, Eleni, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Shrestha, Samyut, additional, Fahrni, Gregor, additional, Osswald, Stefan, additional, López, Beatriz, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Steude, Jana, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Nowalany-Kozielska, Ewa, additional, Muzyk, Piotr, additional, Geigy, Nicolas, additional, and Rentsch, Katharina, additional

Published
2019
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24. Comparison of fourteen rule-out strategies for acute myocardial infarction

Author

Wildi, Karin, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wussler, Desiree, additional, Giménez, Maria Rubini, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Dietsche, Sebastian, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Morawiec, Beata, additional, Miró, Òscar, additional, Javier Martin-Sanchez, F., additional, Subramaniam, Sinthuri, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Mueller, Deborah, additional, Sazgary, Lorraine, additional, Marbot, Stella, additional, Sabti, Zaid, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, López, Beatriz, additional, Agüero, María Martínez, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Muzyk, Piotr, additional, Rentsch, Katharina, additional, and von Eckardstein, Arnold, additional

Published
2019
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25. Circadian, weekly, seasonal, and temperature-dependent patterns of syncope aetiology in patients at increased risk of cardiac syncope

Author

Du Fay De Lavallaz, Jeanne, Badertscher, Patrick, Nestelberger, Thomas, Flores, Dayana, Miró, Òscar, Salgado, Emilio, Geigy, Nicolas, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Di Somma, Salvatore, Peacock, W. Frank, Kawecki, Damian, Boeddinghaus, Jasper, Twerenbold, Raphael, Puelacher, Christian, Wussler, Desiree, Strebel, Ivo, Keller, Dagmar I., Poepping, Imke, Kühne, Michael, Reichlin, Tobias, Mueller, Christian, Giménez, Maria Rubini, Walter, Joan, Kozhuharov, Nikola, Shrestha, Samyut, Mueller, Deborah, Sazgary, Lorraine, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Freese, Michael, Stelzig, Claudia, Meissner, Kathrin, Kulangara, Caroline, Hartmann, Beate, Ferel, Ina, Sabti, Zaid, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, Von Eckardstein, Arnold, Buser, Andreas, Kloos, Wanda, Lohrmann, Jens, Osswald, Stefan, Du Fay De Lavallaz, Jeanne, Badertscher, Patrick, Nestelberger, Thomas, Flores, Dayana, Miró, Òscar, Salgado, Emilio, Geigy, Nicolas, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Di Somma, Salvatore, Peacock, W. Frank, Kawecki, Damian, Boeddinghaus, Jasper, Twerenbold, Raphael, Puelacher, Christian, Wussler, Desiree, Strebel, Ivo, Keller, Dagmar I., Poepping, Imke, Kühne, Michael, Reichlin, Tobias, Mueller, Christian, Giménez, Maria Rubini, Walter, Joan, Kozhuharov, Nikola, Shrestha, Samyut, Mueller, Deborah, Sazgary, Lorraine, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Freese, Michael, Stelzig, Claudia, Meissner, Kathrin, Kulangara, Caroline, Hartmann, Beate, Ferel, Ina, Sabti, Zaid, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, Von Eckardstein, Arnold, Buser, Andreas, Kloos, Wanda, Lohrmann, Jens, and Osswald, Stefan

Abstract

Aims It is unknown whether cardiac syncope, and possibly also other syncope aetiologies exhibit circadian, weekly, seasonal, and temperature-dependent patterns. Methods and results We prospectively recorded the exact time, date, and outside temperature of syncope of patients >40 years old presenting with syncope to the emergency department in a diagnostic multicentre study. Two independent cardiologists/emergency physicians adjudicated the final diagnosis based on all information becoming available during clinical work-up including 1-year follow-up. Among 1230 patients, the adjudicated aetiology was cardiac in 14.6%, reflex in 39.2%, orthostatic in 25.7%, other non-cardiac in 9.7%, and unknown in 10.8% of patients. All syncope aetiologies occurred much more frequently during the day when compared with the night (P < 0.01). While reflex and orthostatic syncope showed a broad peak of prevalence with 80.9% of these events occurring between 4 am and 4 pm, cardiac syncope showed a narrow peak of prevalence with 70.1% of all events occurring between 8 am and 2 pm. A weekly pattern was present for most syncope aetiologies, with events occurring mainly from Monday to Friday (P < 0.01). Reflex syncope displayed a seasonal rhythm and was more common in winter (P < 0.01), while cardiac syncope stayed constant over the year. Syncope occurred most often when the outside temperature was coldest. Overall the patterns observed for cardiac syncope were similar to the patterns observed for its differential diagnosis. Conclusion Syncope aetiologies in patients >40 years old display circadian, weekly, seasonal, and temperature-dependent patterns. Unfortunately, these patterns do not allow to reliably differentiate cardiac syncope from other aetiologies.

Published
2019

26. Prevalence of pulmonary embolism in patients with syncope

Author

Badertscher, Patrick, du Fay de Lavallaz, Jeanne, Hammerer-Lercher, Angelika, Nestelberger, Thomas, Zimmermann, Tobias, Geiger, Marc, Imahorn, O., Miró, Òscar, Salgado, Emilio, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Di Somma, Salvatore, Peacock, W. Frank, Keller, Dagmar I., Costabel, Juan Pablo, Walter, Joan, Boeddinghaus, Jasper, Twerenbold, Raphael, Méndez, Adriana, Gospodinov, B., Puelacher, Christian, Wussler, Desiree, Koechlin, Luca, Kawecki, Damian, Geigy, Nicolas, Strebel, Ivo, Lohrmann, Jens, Kühne, Michael, Reichlin, Tobias, Mueller, Christian, Rubini Giménez, M., Kozhuharov, Nikola, Shrestha, Samyut, Sazgary, Lorraine, Morawiec, B., Muzyk, P., Nowalany-Kozielska, Ewa, Bustamante Mandrión, José, Poepping, Imke, Freese, Michael, Meissner, Kathrin, Kulangara, Caroline, Fuenzalida Inostroza, Carolina Isabel, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, von Eckardstein, Arnold, Buser, Andreas, Kloos, W., Steude, Jana, Osswald, Stefan, Badertscher, Patrick, du Fay de Lavallaz, Jeanne, Hammerer-Lercher, Angelika, Nestelberger, Thomas, Zimmermann, Tobias, Geiger, Marc, Imahorn, O., Miró, Òscar, Salgado, Emilio, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Di Somma, Salvatore, Peacock, W. Frank, Keller, Dagmar I., Costabel, Juan Pablo, Walter, Joan, Boeddinghaus, Jasper, Twerenbold, Raphael, Méndez, Adriana, Gospodinov, B., Puelacher, Christian, Wussler, Desiree, Koechlin, Luca, Kawecki, Damian, Geigy, Nicolas, Strebel, Ivo, Lohrmann, Jens, Kühne, Michael, Reichlin, Tobias, Mueller, Christian, Rubini Giménez, M., Kozhuharov, Nikola, Shrestha, Samyut, Sazgary, Lorraine, Morawiec, B., Muzyk, P., Nowalany-Kozielska, Ewa, Bustamante Mandrión, José, Poepping, Imke, Freese, Michael, Meissner, Kathrin, Kulangara, Caroline, Fuenzalida Inostroza, Carolina Isabel, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, von Eckardstein, Arnold, Buser, Andreas, Kloos, W., Steude, Jana, and Osswald, Stefan

Abstract

Background: The prevalence of pulmonary embolism (PE) in patients presenting with syncope to the emergency department (ED) is largely unknown. This information, however, is necessary to balance the potential medical benefit or harm of systematic PE screening in patients presenting with syncope to the ED. Objectives: This study sought to determine the prevalence of PE in patients with syncope. Methods: Unselected patients presenting with syncope to the ED were prospectively enrolled in a diagnostic multicenter study. Pre-test clinical probability for PE was assessed using the 2-level Wells score and the results of D-dimer testing using age-adapted cutoffs. Presence of PE was evaluated by imaging modalities, when ordered as part of the clinical assessment by the treating ED physician or by long-term follow-up data. Results: Long-term follow-up was complete in 1,380 patients (99%) at 360 days and 1,156 patients (83%) at 720 days. Among 1,397 patients presenting with syncope to the ED, PE was detected at presentation in 19 patients (1.4%; 95% confidence interval [CI]: 0.87% to 2.11%). The incidence of new PEs or cardiovascular death during 2-year follow-up was 0.9% (95% CI: 0.5% to 1.5%). In the subgroup of patients hospitalized (47%), PE was detected at presentation in 15 patients (2.3%; 95% CI: 1.4% to 3.7%). The incidence of new PEs or cardiovascular death during 2-year follow-up was 0.9% (95% CI: 0.4% to 2.0%). Conclusions: PE seems to be a rather uncommon cause of syncope among patients presenting to the ED. Therefore, systematic PE-screening in all patients with syncope does not seem warranted. (BAsel Syncope EvaLuation Study [BASEL IX]; NCT01548352)

Published
2019

27. Diagnosis of acute myocardial infarction in the presence of left bundle branch block

Author

Nestelberger, Thomas, Cullen, Louise, Lindahl, Bertil, Reichlin, Tobias, Greenslade, Jaimi H., Giannitsis, Evangelos, Christ, Michael, Morawiec, Beata, Miro, Oscar, Martín-Sánchez, Francisco Javier, Wussler, Desiree Nadine, Koechlin, Luca, Twerenbold, Raphael, Parsonage, William, Boeddinghaus, Jasper, Rubini Gimenez, Maria, Puelacher, Christian, Wildi, Karin, Buerge, Tobias, Badertscher, Patrick, DuFaydeLavallaz, Jeanne, Strebel, Ivo, Croton, Lukas, Bendig, Garnet, Osswald, Stefan, Pickering, John William, Than, Martin, Mueller, Christian, Hillinger, Petra, Grimm, Karin, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Stelzig, Claudia, Freese, Michael, Sabti, Zaid, Walter, Joan, Sazgary, Lorraine, Kulangara, Caroline, Meissner, Kathrin, Mueller, Deborah, Lopez, Beatriz, Salgado, Emilio, Adrada, Esther Rodríguez, Kawecki, Damian, Parenica, Jiri, Ganovska, Eva, Rentsch, Katharina, Buser, Andreas, Lohrmann, Jens, Bingisser, Roland, Shrestha, Samyut, Stallone, Fabio, Abaecherli, Roger, McCord, James, Nowak, Richard, Body, Richard, DeFilippi, Christopher R., Christenson, Robert H., Panteghini, Mauro, Plebani, Mario, Verschuren, Franck, French, John, Weiser, Silvia, Dinkel, Carina, Keller, Dagmar I., Geigy, Nicolas, Nestelberger, Thomas, Cullen, Louise, Lindahl, Bertil, Reichlin, Tobias, Greenslade, Jaimi H., Giannitsis, Evangelos, Christ, Michael, Morawiec, Beata, Miro, Oscar, Martín-Sánchez, Francisco Javier, Wussler, Desiree Nadine, Koechlin, Luca, Twerenbold, Raphael, Parsonage, William, Boeddinghaus, Jasper, Rubini Gimenez, Maria, Puelacher, Christian, Wildi, Karin, Buerge, Tobias, Badertscher, Patrick, DuFaydeLavallaz, Jeanne, Strebel, Ivo, Croton, Lukas, Bendig, Garnet, Osswald, Stefan, Pickering, John William, Than, Martin, Mueller, Christian, Hillinger, Petra, Grimm, Karin, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Stelzig, Claudia, Freese, Michael, Sabti, Zaid, Walter, Joan, Sazgary, Lorraine, Kulangara, Caroline, Meissner, Kathrin, Mueller, Deborah, Lopez, Beatriz, Salgado, Emilio, Adrada, Esther Rodríguez, Kawecki, Damian, Parenica, Jiri, Ganovska, Eva, Rentsch, Katharina, Buser, Andreas, Lohrmann, Jens, Bingisser, Roland, Shrestha, Samyut, Stallone, Fabio, Abaecherli, Roger, McCord, James, Nowak, Richard, Body, Richard, DeFilippi, Christopher R., Christenson, Robert H., Panteghini, Mauro, Plebani, Mario, Verschuren, Franck, French, John, Weiser, Silvia, Dinkel, Carina, Keller, Dagmar I., and Geigy, Nicolas

Abstract

Objective Patients with suspected acute myocardial infarction (AMI) in the setting of left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to the clinician. Methods We prospectively evaluated the incidence of AMI and diagnostic performance of specific ECG and high-sensitivity cardiac troponin (hs-cTn) criteria in patients presenting with chest discomfort to 26 emergency departments in three international, prospective, diagnostic studies. The final diagnosis of AMI was centrally adjudicated by two independent cardiologists according to the universal definition of myocardial infarction. Results Among 8830 patients, LBBB was present in 247 (2.8%). AMI was the final diagnosis in 30% of patients with LBBB, with similar incidence in those with known LBBB versus those with presumably new LBBB (29% vs 35%, p=0.42). ECG criteria had low sensitivity (1%-12%) but high specificity (95%-100%) for AMI. The diagnostic accuracy as quantified by the receiver operating characteristics (ROC) curve of hs-cTnT and hs-cTnI concentrations at presentation (area under the ROC curve (AUC) 0.91, 95% CI 0.85 to 0.96 and AUC 0.89, 95% CI 0.83 to 0.95), as well as that of their 0/1-hour and 0/2-hour changes, was very high. A diagnostic algorithm combining ECG criteria with hs-cTnT/I concentrations and their absolute changes at 1 hour or 2 hours derived in cohort 1 (45 of 45(100%) patients with AMI correctly identified) showed high efficacy and accuracy when externally validated in cohorts 2 and 3 (28 of 29 patients, 97%). Conclusion Most patients presenting with suspected AMI and LBBB will be found to have diagnoses other than AMI. Combining ECG criteria with hs-cTnT/I testing at 0/1 hour or 0/2 hours allows early and accurate diagnosis of AMI in LBBB. Trial registration number APACE: NCT00470587; ADAPT: ACTRN12611001069943; TRAPID-AMI: RD001107;Results.

Published
2019

28. Two-hour algorithm for rapid triage of suspected acute myocardial infarction using a high-sensitivity cardiac troponin I assay

Author

Nestelberger, Thomas, Boeddinghaus, Jasper, Greenslade, Jaimi, Parsonage, William A., Than, Martin, Wussler, Desiree, Lopez-Ayala, Pedro, Zimmermann, Tobias, Meier, Mario, Troester, Valentina, Badertscher, Patrick, Koechlin, Luca, Wildi, Karin, Anwar, Mahnoor, Freese, Michael, Keller, Dagmar I., Reichlin, Tobias, Twerenbold, Raphael, Cullen, Louise, Mueller, Christian, Puelacher, Christian, Du Fay De Lavallaz, Jeanne, Giménez, Maria Rubini, Strebel, Ivo, Walter, Joan, Huber, Jeffrey, Christ, Michael, Kozhuharov, Nikola, Gualandro, Danielle M., Potlukova, Eliska, Baumgartner, Benjamin, Hafner, Benjamin, Rent-Sch, Katharina, Miró, Òscar, Fuenzalida, Carolina, Gil, Beatriz, Javier Martin-Sanchez, F., Kawecki, Damian, Geigy, Nicolas, Meissner, Kathrin, Kulangara, Caroline, López, Beatriz, Adrada, Esther Rodriguez, Ganovská, Eva, Lohrmann, Jens, Kloos, Wanda, Steude, Jana, Buser, Andreas, Von Eckardstein, Arnold, Nowalany-Kozielska, Ewa, Muzyk, Piotr, Nestelberger, Thomas, Boeddinghaus, Jasper, Greenslade, Jaimi, Parsonage, William A., Than, Martin, Wussler, Desiree, Lopez-Ayala, Pedro, Zimmermann, Tobias, Meier, Mario, Troester, Valentina, Badertscher, Patrick, Koechlin, Luca, Wildi, Karin, Anwar, Mahnoor, Freese, Michael, Keller, Dagmar I., Reichlin, Tobias, Twerenbold, Raphael, Cullen, Louise, Mueller, Christian, Puelacher, Christian, Du Fay De Lavallaz, Jeanne, Giménez, Maria Rubini, Strebel, Ivo, Walter, Joan, Huber, Jeffrey, Christ, Michael, Kozhuharov, Nikola, Gualandro, Danielle M., Potlukova, Eliska, Baumgartner, Benjamin, Hafner, Benjamin, Rent-Sch, Katharina, Miró, Òscar, Fuenzalida, Carolina, Gil, Beatriz, Javier Martin-Sanchez, F., Kawecki, Damian, Geigy, Nicolas, Meissner, Kathrin, Kulangara, Caroline, López, Beatriz, Adrada, Esther Rodriguez, Ganovská, Eva, Lohrmann, Jens, Kloos, Wanda, Steude, Jana, Buser, Andreas, Von Eckardstein, Arnold, Nowalany-Kozielska, Ewa, and Muzyk, Piotr

Abstract

BACKGROUND We aimed to derive and externally validate a 0/2-h algorithm using the high-sensitivity cardiac troponin I (hs-cTnI)-Access assay. METHODS We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI) in 2 prospective diagnostic studies using central adjudication. Two independent cardiologists adjudicated the final diagnosis, including all available medical information including cardiac imaging. hs-cTnI-Access concentrations were measured at presentation and after 2 h in a blinded fashion. RESULTS AMI was the adjudicated final diagnosis in 164 of 1131 (14.5%) patients in the derivation cohort. Rule-out by the hs-cTnI-Access 0/2-h algorithm was defined as 0-h hs-cTnI-Access concentration <4 ng/L in patients with an onset of chest pain >3 h (direct rule-out) or a 0-h hs-cTnI-Access concentration <5 ng/L and an absolute change within 2 h <5 ng/L in all other patients. Derived thresholds for rule-in were a 0-h hs-cTnI-Access concentration ≥50 ng/L (direct rule-in) or an absolute change within 2 h ≥20 ng/L. In the derivation cohort, these cutoffs ruled out 55% of patients with a negative predictive value (NPV) of 99.8% (95% CI, 99.3–100) and sensitivity of 99.4% (95% CI, 96.5–99.9), and ruled in 30% of patients with a positive predictive value (PPV) of 73% (95% CI, 66.1–79). In the validation cohort, AMI was the adjudicated final diagnosis in 88 of 1280 (6.9%) patients. These cutoffs ruled out 77.9% of patients with an NPV of 99.8% (95% CI, 99.3–100) and sensitivity of 97.7% (95% CI, 92.0–99.7), and ruled in 5.8% of patients with a PPV of 77% (95% CI, 65.8–86) in the validation cohort. CONCLUSIONS Safety and efficacy of the l hs-cTnI-Access 0/2-h algorithm for triage toward rule-out or rule-in of AMI are very high.

Published
2019

30. Strengthening participation through decentralisation: findings on local economic development in Kyrgyzstan

Author

Deutsches Institut für Entwicklungspolitik gGmbH, Grävingholt, Jörn, Doerr, Bettina, Meissner, Kathrin, Pletziger, Stefan, Rümker, Julia von, Weikert, Jochen, Deutsches Institut für Entwicklungspolitik gGmbH, Grävingholt, Jörn, Doerr, Bettina, Meissner, Kathrin, Pletziger, Stefan, Rümker, Julia von, and Weikert, Jochen

Abstract

"Decentralisation and local government reform are important elements of many developing countries' efforts to improve state governance. Nonetheless, local governments often appear to be very limited in their ability to meet the high expectations associated with decentralisation and the introduction of local self-government. Kyrgyzstan in Central Asia is a typical example of a country where decentralisation efforts have been on the political agenda for more than a decade but actual results are less than satisfactory. While there is widespread agreement among experts about the diagnosis as such, so far little research has been done on the exact reasons for this situation and their effects on the Kyrgyz Republic's development potential. To address this question, this study analyses one particular aspect of decentralisation in the Kyrgyz Republic, namely its impact on popular participation in the design and implementation of local economic development policies. Proceeding from this analysis, the study derives conclusions and recommendations for the Kyrgyz government and other official bodies, local NGOs and international donors." (author's abstract)

Published
2010

34. Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and Heart Failure Rehospitalization Among Patients With Acute Heart Failure: The GALACTIC Randomized Clinical Trial.

Author

Kozhuharov N, Goudev A, Flores D, Maeder MT, Walter J, Shrestha S, Gualandro DM, de Oliveira Junior MT, Sabti Z, Müller B, Noveanu M, Socrates T, Ziller R, Bayés-Genís A, Sionis A, Simon P, Michou E, Gujer S, Gori T, Wenzel P, Pfister O, Conen D, Kapos I, Kobza R, Rickli H, Breidthardt T, Münzel T, Erne P, Mueller C, Mueller, Erne, Müller, Rickli, Maeder, Tavares de Oliveira Jr, Münzel, Bayés-Genís, Sionis, Goudev, Dimov, Hartwiger, Arenja N, Glatz, Herr, Isenrich, Mosimann, Twerenbold, Boeddinghaus, Nestelberger, Puelacher, Freese, Vögele, Meissner, Martin, Strebel, Wussler, Schumacher, Osswald, Vogt, Hilti, Barata, Schneider, Schwarz, Fitze, Hartwiger, Arenja, Glatz, Herr, Isenrich, Mosimann, Twerenbold, Boeddinghaus, Nestelberger, Puelacher, Freese, Vögele, Meissner, Martin, Strebel, Wussler, Schumacher, Osswald, Vogt, Hilti, Barata, Schneider, Schwarz, Fitze, Arenja, Rentsch, Bossa, Jallad, Soeiro, Georgiev, Jansen, Gebel, Bossard, and Christ

Subjects
Acute Disease, Aged, Aged, 80 and over, Cause of Death, Comorbidity, Drug Administration Schedule, Female, Heart Failure mortality, Hospitalization, Humans, Male, Patient Readmission statistics & numerical data, Vasodilator Agents adverse effects, Heart Failure drug therapy, Vasodilator Agents administration & dosage
Abstract

Importance: Short-term infusions of single vasodilators, usually given in a fixed dose, have not improved outcomes in patients with acute heart failure (AHF)., Objective: To evaluate the effect of a strategy that emphasized early intensive and sustained vasodilation using individualized up-titrated doses of established vasodilators in patients with AHF., Design, Setting, and Participants: Randomized, open-label blinded-end-point trial enrolling 788 patients hospitalized for AHF with dyspnea, increased plasma concentrations of natriuretic peptides, systolic blood pressure of at least 100 mm Hg, and plan for treatment in a general ward in 10 tertiary and secondary hospitals in Switzerland, Bulgaria, Germany, Brazil, and Spain. Enrollment began in December 2007 and follow-up was completed in February 2019., Interventions: Patients were randomized 1:1 to a strategy of early intensive and sustained vasodilation throughout the hospitalization (n = 386) or usual care (n = 402). Early intensive and sustained vasodilation was a comprehensive pragmatic approach of maximal and sustained vasodilation combining individualized doses of sublingual and transdermal nitrates, low-dose oral hydralazine for 48 hours, and rapid up-titration of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or sacubitril-valsartan., Main Outcomes and Measures: The primary end point was a composite of all-cause mortality or rehospitalization for AHF at 180 days., Results: Among 788 patients randomized, 781 (99.1%; median age, 78 years; 36.9% women) completed the trial and were eligible for primary end point analysis. Follow-up at 180 days was completed for 779 patients (99.7%). The primary end point, a composite of all-cause mortality or rehospitalization for AHF at 180 days, occurred in 117 patients (30.6%) in the intervention group (including 55 deaths [14.4%]) and in 111 patients (27.8%) in the usual care group (including 61 deaths [15.3%]) (absolute difference for the primary end point, 2.8% [95% CI, -3.7% to 9.3%]; adjusted hazard ratio, 1.07 [95% CI, 0.83-1.39]; P = .59). The most common clinically significant adverse events with early intensive and sustained vasodilation vs usual care were hypokalemia (23% vs 25%), worsening renal function (21% vs 20%), headache (26% vs 10%), dizziness (15% vs 10%), and hypotension (8% vs 2%)., Conclusions and Relevance: Among patients with AHF, a strategy of early intensive and sustained vasodilation, compared with usual care, did not significantly improve a composite outcome of all-cause mortality and AHF rehospitalization at 180 days., Trial Registration: ClinicalTrials.gov Identifier: NCT00512759.

Published
2019
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