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2. Impact of progressive aortic regurgitation on outcomes after left ventricular assist device implantation

Author

Gasparovic, Hrvoje, Jakus, Nina, Brugts, Jasper J., Pouleur, Anne-Catherine, Timmermans, Philippe, Rubiś, Pawel, Gaizauskas, Edvinas, Van Craenenbroeck, Emeline M., Barge-Caballero, Eduardo, Grundmann, Sebastian, Paolillo, Stefania, D’Amario, Domenico, Braun, Oscar Ö., Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Planinc, Ivo, Lovric, Daniel, Flammer, Andreas J., Petricevic, Mate, Biocina, Bojan, Lund, Lars H., Milicic, Davor, Ruschitzka, Frank, and Cikes, Maja

Published
2022
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7. X-ray phase contrast imaging of endomyocardial biopsy samples preserved in formalin and embedded in paraffin – a comparison of tissue preparation methods

Author

Škreb, Nikola, primary, Lončarić, Filip, additional, Bonnin, Anne, additional, Dejea, Hector, additional, Ilić, Ivana, additional, Gašparović, Hrvoje, additional, Skorić, Boško, additional, Bijnens, Bart, additional, Miličić, Davor, additional, Planinc, Ivo, additional, and Čikeš, Maja, additional

Published
2023
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9. The Transcatheter Mitral Valve Replacement program at the University Hospital Centre Zagreb – a case series

Author

Rešković Lukšić, Vlatka, primary, Jakšić Jurinjak, Sandra, additional, Bulum, Joško, additional, Šafradin, Ivica, additional, Krželj, Kristina, additional, Čikeš, Maja, additional, Planinc, Ivo, additional, Gjuras, Karlo, additional, Miličić, Davor, additional, Gašparović, Hrvoje, additional, and Šeparović Hanževački, Jadranka, additional

Published
2023
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10. Multiorgan failure secondary to influenza A associated hemophagocytic syndrome

Author

Šipuš, Dubravka, primary, Perčin, Luka, additional, Milinković, Anica, additional, Fabijanović, Dora, additional, Planinc, Ivo, additional, Pašalić, Marijan, additional, Jakuš, Nina, additional, Jurin, Hrvoje, additional, Samardžić, Jure, additional, Skorić, Boško, additional, Čikeš, Maja, additional, Hude Dragičević, Ida, additional, Miličić, Davor, additional, and Lovrić, Daniel, additional

Published
2023
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13. How does age affect outcomes after left ventricular assist device implantation:results from the PCHF-VAD registry

Author

Radhoe, Sumant P., Veenis, Jesse F., Jakus, Nina, Timmermans, Philippe, Pouleur, Anne Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M., Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar, Gkouziouta, Aggeliki, Planinc, Ivo, Samardzic, Jure, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J., Gasparovic, Hrvoje, Biocina, Bojan, Lund, Lars H., Milicic, Davor, Ruschitzka, Frank, Cikes, Maja, Brugts, Jasper J., Radhoe, Sumant P., Veenis, Jesse F., Jakus, Nina, Timmermans, Philippe, Pouleur, Anne Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M., Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar, Gkouziouta, Aggeliki, Planinc, Ivo, Samardzic, Jure, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J., Gasparovic, Hrvoje, Biocina, Bojan, Lund, Lars H., Milicic, Davor, Ruschitzka, Frank, Cikes, Maja, and Brugts, Jasper J.

Abstract

Aims: Use of left ventricular assist devices (LVADs) in older patients has increased, and assessing outcomes in older LVAD recipients is important. Therefore, this study aimed to investigate associations between age and outcomes after continuous-flow LVAD (cf-LVAD) implantation. Methods and results: Cf-LVAD patients from the multicentre European PCHF-VAD registry were included and categorized into those <50, 50–64, and ≥65 years old. The primary endpoint was all-cause mortality. Among secondary outcomes were heart failure (HF) hospitalizations, right ventricular (RV) failure, haemocompatibility score, bleeding events, non-fatal thromboembolic events, and device-related infections. Of 562 patients, 184 (32.7%) were <50, 305 (54.3%) were aged 50–64, whereas 73 (13.0%) were ≥65 years old. Median follow-up was 1.1 years. Patients in the oldest age group were significantly more often designated as destination therapy (DT) candidates (61%). A 10 year increase in age was associated with a significantly higher risk of mortality (hazard ratio [HR] 1.34, 95% confidence interval [CI] [1.15–1.57]), intracranial bleeding (HR 1.49, 95% CI [1.10–2.02]), and non-intracranial bleeding (HR 1.30, 95% CI [1.09–1.56]), which was confirmed by a higher mean haemocompatibility score (1.37 vs. 0.77, oldest vs. youngest groups, respectively, P = 0.033). Older patients suffered from less device-related infections requiring systemic antibiotics. No age-related differences were observed in HF-related hospitalizations, ventricular arrhythmias, pump thrombosis, non-fatal thromboembolic events, or RV failure. Conclusions: In the PCHF-VAD registry, higher age was associated with increased risk of mortality, and especially with increased risk of major bleeding, which is particularly relevant for the DT population. The risks of HF hospitalizations, pump thrombosis, ventricular arrhythmia, or RV failure were comparable. Strikingly, older patients had less device-related infections.

Published
2023

14. Sex-related differences in left ventricular assist device utilization and outcomes:results from the PCHF-VAD registry

Author

Radhoe, Sumant P., Jakus, Nina, Veenis, Jesse F., Timmermans, Philippe, Pouleur, Anne Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M., Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar, Gkouziouta, Aggeliki, Planinc, Ivo, Macek, Jana Ljubas, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J., Gasparovic, Hrvoje, Biocina, Bojan, Milicic, Davor, Lund, Lars H., Ruschitzka, Frank, Brugts, Jasper J., Cikes, Maja, Radhoe, Sumant P., Jakus, Nina, Veenis, Jesse F., Timmermans, Philippe, Pouleur, Anne Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M., Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar, Gkouziouta, Aggeliki, Planinc, Ivo, Macek, Jana Ljubas, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J., Gasparovic, Hrvoje, Biocina, Bojan, Milicic, Davor, Lund, Lars H., Ruschitzka, Frank, Brugts, Jasper J., and Cikes, Maja

Abstract

Aims: Data on sex and left ventricular assist device (LVAD) utilization and outcomes have been conflicting and mostly confined to US studies incorporating older devices. This study aimed to investigate sex-related differences in LVAD utilization and outcomes in a contemporary European LVAD cohort. Methods and results: This analysis is part of the multicentre PCHF-VAD registry studying continuous-flow LVAD patients. The primary outcome was all-cause mortality. Secondary outcomes included ventricular arrhythmias, right ventricular failure, bleeding, thromboembolism, and the haemocompatibility score. Multivariable Cox regression models were used to assess associations between sex and outcomes. Overall, 457 men (81%) and 105 women (19%) were analysed. At LVAD implant, women were more often in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 or 2 (55% vs. 41%, P = 0.009) and more often required temporary mechanical circulatory support (39% vs. 23%, P = 0.001). Mean age was comparable (52.1 vs. 53.4 years, P = 0.33), and median follow-up duration was 344 [range 147–823] days for women and 435 [range 190–816] days for men (P = 0.40). No significant sex-related differences were found in all-cause mortality (hazard ratio [HR] 0.79 for female vs. male sex, 95% confidence interval [CI] [0.50–1.27]). Female LVAD patients had a lower risk of ventricular arrhythmias (HR 0.56, 95% CI [0.33–0.95]) but more often experienced right ventricular failure. No significant sex-related differences were found in other outcomes. Conclusions: In this contemporary European cohort of LVAD patients, far fewer women than men underwent LVAD implantation despite similar clinical outcomes. This is important as the proportion of female LVAD patients (19%) was lower than the proportion of females with advanced HF as reported in previous studies, suggesting underutilization. Also, female patients were remarkably more often in INTERMACS profile 1 or 2, suggestin

Published
2023

15. How does age affect outcomes after left ventricular assist device implantation: results from the PCHF-VAD registry

Author

Radhoe, Sumant P; https://orcid.org/0000-0002-1070-6715, Veenis, Jesse F, Jakus, Nina, Timmermans, Philippe, Pouleur, Anne-Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M, Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar Ö, Gkouziouta, Aggeliki, Planinc, Ivo, Samardzic, Jure, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J; https://orcid.org/0000-0002-1373-0630, Gasparovic, Hrvoje, Biocina, Bojan, Lund, Lars H; https://orcid.org/0000-0003-1411-4482, Miličić, Davor, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, Cikes, Maja, Brugts, Jasper J, Radhoe, Sumant P; https://orcid.org/0000-0002-1070-6715, Veenis, Jesse F, Jakus, Nina, Timmermans, Philippe, Pouleur, Anne-Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M, Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar Ö, Gkouziouta, Aggeliki, Planinc, Ivo, Samardzic, Jure, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J; https://orcid.org/0000-0002-1373-0630, Gasparovic, Hrvoje, Biocina, Bojan, Lund, Lars H; https://orcid.org/0000-0003-1411-4482, Miličić, Davor, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, Cikes, Maja, and Brugts, Jasper J

Abstract

AIMS: Use of left ventricular assist devices (LVADs) in older patients has increased, and assessing outcomes in older LVAD recipients is important. Therefore, this study aimed to investigate associations between age and outcomes after continuous-flow LVAD (cf-LVAD) implantation. METHODS AND RESULTS: Cf-LVAD patients from the multicentre European PCHF-VAD registry were included and categorized into those <50, 50-64, and ≥65 years old. The primary endpoint was all-cause mortality. Among secondary outcomes were heart failure (HF) hospitalizations, right ventricular (RV) failure, haemocompatibility score, bleeding events, non-fatal thromboembolic events, and device-related infections. Of 562 patients, 184 (32.7%) were <50, 305 (54.3%) were aged 50-64, whereas 73 (13.0%) were ≥65 years old. Median follow-up was 1.1 years. Patients in the oldest age group were significantly more often designated as destination therapy (DT) candidates (61%). A 10 year increase in age was associated with a significantly higher risk of mortality (hazard ratio [HR] 1.34, 95% confidence interval [CI] [1.15-1.57]), intracranial bleeding (HR 1.49, 95% CI [1.10-2.02]), and non-intracranial bleeding (HR 1.30, 95% CI [1.09-1.56]), which was confirmed by a higher mean haemocompatibility score (1.37 vs. 0.77, oldest vs. youngest groups, respectively, P = 0.033). Older patients suffered from less device-related infections requiring systemic antibiotics. No age-related differences were observed in HF-related hospitalizations, ventricular arrhythmias, pump thrombosis, non-fatal thromboembolic events, or RV failure. CONCLUSIONS: In the PCHF-VAD registry, higher age was associated with increased risk of mortality, and especially with increased risk of major bleeding, which is particularly relevant for the DT population. The risks of HF hospitalizations, pump thrombosis, ventricular arrhythmia, or RV failure were comparable. Strikingly, older patients had less device-related infections.

Published
2023

16. Sex-related differences in left ventricular assist device utilization and outcomes: results from the PCHF-VAD registry

Author

Radhoe, Sumant P, Jakus, Nina, Veenis, Jesse F, Timmermans, Philippe, Pouleur, Anne-Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M, Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar Ö, Gkouziouta, Aggeliki, Planinc, Ivo, Macek, Jana Ljubas, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J, Gasparovic, Hrvoje, Biocina, Bojan, Miličić, Davor, Lund, Lars H, Ruschitzka, Frank, Brugts, Jasper J, Cikes, Maja, Cardiology, University of Zurich, and Brugts, Jasper J

Subjects
advanced heart failure, left ventricular assist device, sex, survival, utilization, Male, Survival, Advanced heart failure, Heart Failure / epidemiology, Left ventricular assist device, Heart-Assist Devices / adverse effects, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, Utilization, Treatment Outcome, 10209 Clinic for Cardiology, Humans, Sex, Female, Heart Failure / therapy, Registries, Human medicine, Cardiology and Cardiovascular Medicine
Abstract

AIMS: Data on sex and left ventricular assist device (LVAD) utilization and outcomes have been conflicting and mostly confined to US studies incorporating older devices. This study aimed to investigate sex-related differences in LVAD utilization and outcomes in a contemporary European LVAD cohort. METHODS AND RESULTS: This analysis is part of the multicentre PCHF-VAD registry studying continuous-flow LVAD patients. The primary outcome was all-cause mortality. Secondary outcomes included ventricular arrhythmias, right ventricular failure, bleeding, thromboembolism, and the haemocompatibility score. Multivariable Cox regression models were used to assess associations between sex and outcomes. Overall, 457 men (81%) and 105 women (19%) were analysed. At LVAD implant, women were more often in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 or 2 (55% vs. 41%, P = 0.009) and more often required temporary mechanical circulatory support (39% vs. 23%, P = 0.001). Mean age was comparable (52.1 vs. 53.4 years, P = 0.33), and median follow-up duration was 344 [range 147-823] days for women and 435 [range 190-816] days for men (P = 0.40). No significant sex-related differences were found in all-cause mortality (hazard ratio [HR] 0.79 for female vs. male sex, 95% confidence interval [CI] [0.50-1.27]). Female LVAD patients had a lower risk of ventricular arrhythmias (HR 0.56, 95% CI [0.33-0.95]) but more often experienced right ventricular failure. No significant sex-related differences were found in other outcomes. CONCLUSIONS: In this contemporary European cohort of LVAD patients, far fewer women than men underwent LVAD implantation despite similar clinical outcomes. This is important as the proportion of female LVAD patients (19%) was lower than the proportion of females with advanced HF as reported in previous studies, suggesting underutilization. Also, female patients were remarkably more often in INTERMACS profile 1 or 2, suggesting later referral for LVAD therapy. Additional research in female patients is warranted. ispartof: ESC HEART FAILURE vol:10 issue:2 ispartof: location:England status: Published online

Published
2023

17. A Novel Three-Dimensional Approach Towards Evaluating Endomyocardial Biopsies for Follow-Up After Heart Transplantation: X-Ray Phase Contrast Imaging and Its Agreement With Classical Histopathology

Author

Planinc, Ivo, primary, Ilic, Ivana, additional, Dejea, Hector, additional, Garcia-Canadilla, Patricia, additional, Gasparovic, Hrvoje, additional, Jurin, Hrvoje, additional, Milicic, Davor, additional, Skoric, Bosko, additional, Stampanoni, Marco, additional, Bijnens, Bart, additional, Bonnin, Anne, additional, and Cikes, Maja, additional

Published
2023
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18. Sex‐related differences in left ventricular assist device utilization and outcomes: results from the PCHF‐VAD registry

Author

Radhoe, Sumant P., primary, Jakus, Nina, additional, Veenis, Jesse F., additional, Timmermans, Philippe, additional, Pouleur, Anne‐Catherine, additional, Rubís, Pawel, additional, Van Craenenbroeck, Emeline M., additional, Gaizauskas, Edvinas, additional, Barge‐Caballero, Eduardo, additional, Paolillo, Stefania, additional, Grundmann, Sebastian, additional, D'Amario, Domenico, additional, Braun, Oscar Ö., additional, Gkouziouta, Aggeliki, additional, Planinc, Ivo, additional, Macek, Jana Ljubas, additional, Meyns, Bart, additional, Droogne, Walter, additional, Wierzbicki, Karol, additional, Holcman, Katarzyna, additional, Flammer, Andreas J., additional, Gasparovic, Hrvoje, additional, Biocina, Bojan, additional, Milicic, Davor, additional, Lund, Lars H., additional, Ruschitzka, Frank, additional, Brugts, Jasper J., additional, and Cikes, Maja, additional

Published
2022
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19. How does age affect outcomes after left ventricular assist device implantation: results from the PCHF‐VAD registry

Author

Radhoe, Sumant P., primary, Veenis, Jesse F., additional, Jakus, Nina, additional, Timmermans, Philippe, additional, Pouleur, Anne‐Catherine, additional, Rubís, Pawel, additional, Van Craenenbroeck, Emeline M., additional, Gaizauskas, Edvinas, additional, Barge‐Caballero, Eduardo, additional, Paolillo, Stefania, additional, Grundmann, Sebastian, additional, D'Amario, Domenico, additional, Braun, Oscar Ö., additional, Gkouziouta, Aggeliki, additional, Planinc, Ivo, additional, Samardzic, Jure, additional, Meyns, Bart, additional, Droogne, Walter, additional, Wierzbicki, Karol, additional, Holcman, Katarzyna, additional, Flammer, Andreas J., additional, Gasparovic, Hrvoje, additional, Biocina, Bojan, additional, Lund, Lars H., additional, Milicic, Davor, additional, Ruschitzka, Frank, additional, Cikes, Maja, additional, and Brugts, Jasper J., additional

Published
2022
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20. New paradigm in graft rejection detection in heart transplantation recipients: diagnostic utility of synchrotron X-ray phase contrast imaging (GRAFT-XPCI) - a multi-centric, prospective, observational study protocol

Author

Škreb, Nikola, primary, Lončarić, Filip, additional, Bijnens, Bart, additional, Bonnin, Anne, additional, Dejea, Hector, additional, Farrero Torres, Marta, additional, Garcia Canadilla, Patricia, additional, Lončarić, Sven, additional, López-Sainz, Angela, additional, Gašparović, Hrvoje, additional, Ilić, Ivana, additional, Miličić, Davor, additional, Rudež, Igor, additional, Skorić, Boško, additional, Planinc, Ivo, additional, and Čikeš, Maja, additional

Published
2022
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21. The effect of anticoagulation therapy on perioperative bleeding risk in patients undergoing heart transplantation

Author

Mjehović, Petra, primary, Dubravčić Došen, Mia, additional, Pašalić, Marijan, additional, Čikeš, Maja, additional, Fabijanović, Dora, additional, Jakuš, Nina, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Planinc, Ivo, additional, Samardžić, Jure, additional, Golubić Ćepulić, Branka, additional, Bojanić, Ines, additional, Mazić, Sanja, additional, Čolak, Željko, additional, Gašparović, Hrvoje, additional, Miličić, Davor, additional, and Skorić, Boško, additional

Published
2022
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22. Design and initiation of the Croatian Transthyretin Cardiac Amyloidosis Registry

Author

Planinc, Ivo, primary, Šipuš, Dubravka, additional, Lončarić, Filip, additional, Jakuš, Nina, additional, Fabijanović, Dora, additional, Pašalić, Marijan, additional, Jurin, Hrvoje, additional, Samardžić, Jure, additional, Skorić, Boško, additional, Borovečki, Fran, additional, Miličić, Davor, additional, and Čikeš, Maja, additional

Published
2022
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24. Desensitization procedures in heart transplant recipients: a case series

Author

Dubravčić Došen, Mia, primary, Mjehović, Petra, additional, Šipuš, Dubravka, additional, Čikeš, Maja, additional, Fabijanović, Dora, additional, Jakuš, Nina, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Pašalić, Marijan, additional, Planinc, Ivo, additional, Samardžić, Jure, additional, Burek Kamenarić, Marija, additional, Žunec, Renata, additional, Bojanić, Ines, additional, Mazić, Sanja, additional, Golubić Ćepulić, Branka, additional, Čolak, Željko, additional, Gašparović, Hrvoje, additional, Miličić, Davor, additional, and Skorić, Boško, additional

Published
2022
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25. Clinically suspected post-transplantation myocarditis – a case series

Author

Mjehović, Petra, primary, Dubravčić Došen, Mia, additional, Šipuš, Dubravka, additional, Pašalić, Marijan, additional, Čikeš, Maja, additional, Fabijanović, Dora, additional, Jakuš, Nina, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Planinc, Ivo, additional, Samardžić, Jure, additional, Ilić, Ivana, additional, Čolak, Željko, additional, Gašparović, Hrvoje, additional, Miličić, Davor, additional, and Skorić, Boško, additional

Published
2022
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26. How does age affect outcomes after left ventricular assist device implantation: results from the PCHF-VAD registry

Author

Radhoe, Sumant P, Veenis, Jesse F, Jakus, Nina, Timmermans, Philippe, Pouleur, Anne-Catherine, Rubís, Pawel, Van Craenenbroeck, Emeline M, Gaizauskas, Edvinas, Barge-Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar Ö, Gkouziouta, Aggeliki, Planinc, Ivo, Samardzic, Jure, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Flammer, Andreas J, Gasparovic, Hrvoje, Biocina, Bojan, Lund, Lars H, Miličić, Davor, Ruschitzka, Frank, Cikes, Maja, Brugts, Jasper J, Cardiology, University of Zurich, and Brugts, Jasper J

Subjects
Survival, Advanced heart failure, Destination therapy, Heart Failure / epidemiology, 610 Medicine & health, Arrhythmias, Cardiac, Heart-Assist Devices / adverse effects, Thrombosis / etiology, 2705 Cardiology and Cardiovascular Medicine, Age, advanced heart failure, age, destination therapy, left ventricular assist devices, survival, Treatment Outcome, Left ventricular assist devices, 10209 Clinic for Cardiology, Humans, Human medicine, Heart Failure / therapy, Registries, Cardiology and Cardiovascular Medicine, Aged
Abstract

AIMS: Use of left ventricular assist devices (LVADs) in older patients has increased, and assessing outcomes in older LVAD recipients is important. Therefore, this study aimed to investigate associations between age and outcomes after continuous-flow LVAD (cf-LVAD) implantation. METHODS AND RESULTS: Cf-LVAD patients from the multicentre European PCHF-VAD registry were included and categorized into those

Published
2023
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27. 12th WINFOCUS world congress on ultrasound in emergency and critical care

Author

Acar, Yahya, Tezel, Onur, Salman, Necati, Cevik, Erdem, Algaba-Montes, Margarita, Oviedo-García, Alberto, Patricio-Bordomás, Mayra, Mahmoud, Mustafa Z., Sulieman, Abdelmoneim, Ali, Abbas, Mustafa, Alrayah, Abdelrahman, Ihab, Bahar, Mustafa, Ali, Osama, Lester Kirchner, H., Prosen, Gregor, Anzic, Ajda, Leeson, Paul, Bahreini, Maryam, Rasooli, Fatemeh, Hosseinnejad, Houman, Blecher, Gabriel, Meek, Robert, Egerton-Warburton, Diana, Ćuti, Edina Ćatić, Belina, Stanko, Vančina, Tihomir, Kovačević, Idriz, Rustemović, Nadan, Chang, Ikwan, Lee, Jin Hee, Kwak, Young Ho, Kim, Do Kyun, Cheng, Chi-Yung, Pan, Hsiu-Yung, Kung, Chia-Te, Ćurčić, Ela, Pritišanac, Ena, Planinc, Ivo, Medić, Marijana Grgić, Radonić, Radovan, Fasina, Abiola, Dean, Anthony J., Panebianco, Nova L., Henwood, Patricia S., Fochi, Oliviero, Favarato, Moreno, Bonanomi, Ezio, Tomić, Ivan, Ha, Youngrock, Toh, Hongchuen, Harmon, Elizabeth, Chan, Wilma, Baston, Cameron, Morrison, Gail, Shofer, Frances, Hua, Angela, Kim, Sharon, Tsung, James, Gunaydin, Isa, Kekec, Zeynep, Ay, Mehmet Oguzhan, Kim, Jinjoo, Kim, Jinhyun, Choi, Gyoosung, Shim, Dowon, Lee, Ji-Han, Ambrozic, Jana, Prokselj, Katja, Lucovnik, Miha, Simenc, Gabrijela Brzan, Mačiulienė, Asta, Maleckas, Almantas, Kriščiukaitis, Algimantas, Mačiulis, Vytautas, Macas, Andrius, Mohite, Sharad, Narancsik, Zoltan, Možina, Hugon, Nikolić, Sara, Hansel, Jan, Petrovčič, Rok, Mršić, Una, Orlob, Simon, Lerchbaumer, Markus, Schönegger, Niklas, Kaufmann, Reinhard, Pan, Chun-I, Wu, Chien-Hung, Pasquale, Sarah, Doniger, Stephanie J., Yellin, Sharon, Chiricolo, Gerardo, Potisek, Maja, Drnovšek, Borut, Leskovar, Boštjan, Robinson, Kristine, Kraft, Clara, Moser, Benjamin, Davis, Stephen, Layman, Shelley, Sayeed, Yusef, Minardi, Joseph, Pasic, Irmina Sefic, Dzananovic, Amra, Pasic, Anes, Zubovic, Sandra Vegar, Hauptman, Ana Godan, Brajkovic, Ana Vujaklija, Babel, Jaksa, Peklic, Marina, Radonic, Vedran, Bielen, Luka, Ming, Peh Wee, Yezid, Nur hafiza, Mohammed, Fatahul Laham, Huda, Zainal Abidin, Ismail, Wan Nasarudin Wan, Isa, W. Yus Haniff W., Fauzi, Hashairi, Seeva, Praveena, and Mazlan, Mohd Zulfakar

Published
2016
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28. Impact of progressive aortic regurgitation on outcomes after left ventricular assist device implantation.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Département cardiovasculaire, Gasparovic, Hrvoje, Jakus, Nina, Brugts, Jasper J, Pouleur, Anne-Catherine, Timmermans, Philippe, Rubiś, Pawel, Gaizauskas, Edvinas, Van Craenenbroeck, Emeline M, Barge-Caballero, Eduardo, Grundmann, Sebastian, Paolillo, Stefania, D'Amario, Domenico, Braun, Oscar Ö, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Planinc, Ivo, Lovric, Daniel, Flammer, Andreas J, Petricevic, Mate, Biocina, Bojan, Lund, Lars H, Milicic, Davor, Ruschitzka, Frank, Cikes, Maja, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Département cardiovasculaire, Gasparovic, Hrvoje, Jakus, Nina, Brugts, Jasper J, Pouleur, Anne-Catherine, Timmermans, Philippe, Rubiś, Pawel, Gaizauskas, Edvinas, Van Craenenbroeck, Emeline M, Barge-Caballero, Eduardo, Grundmann, Sebastian, Paolillo, Stefania, D'Amario, Domenico, Braun, Oscar Ö, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Planinc, Ivo, Lovric, Daniel, Flammer, Andreas J, Petricevic, Mate, Biocina, Bojan, Lund, Lars H, Milicic, Davor, Ruschitzka, Frank, and Cikes, Maja

Abstract

Aortic regurgitation (AR) following continuous flow left ventricular assist device implantation (cf-LVAD) may adversely impact outcomes. We aimed to assess the incidence and impact of progressive AR after cf-LVAD on prognosis, biomarkers, functional capacity and echocardiographic findings. In an analysis of the PCHF-VAD database encompassing 12 European heart failure centers, patients were dichotomized according to the progression of AR following LVAD implantation. Patients with de-novo AR or AR progression (AR_1) were compared to patients without worsening AR (AR_0). Among 396 patients (mean age 53 ± 12 years, 82% male), 153 (39%) experienced progression of AR over a median of 1.4 years on LVAD support. Before LVAD implantation, AR_1 patients were less frequently diabetic, had lower body mass indices and higher baseline NT-proBNP values. Progressive AR did not adversely impact mortality (26% in both groups, HR 0.91 [95% CI 0.61-1.36]; P = 0.65). No intergroup variability was observed in NT-proBNP values and 6-minute walk test results at index hospitalization discharge and at 6-month follow-up. However, AR_1 patients were more likely to remain in NYHA class III and had worse right ventricular function at 6-month follow-up. Lack of aortic valve opening was related to de-novo or worsening AR (P < 0.001), irrespective of systolic blood pressure (P = 0.67). Patients commonly experience de-novo or worsening AR when exposed to continuous flow of contemporary LVADs. While reducing effective forward flow, worsening AR did not influence survival. However, less complete functional recovery and worse RV performance among AR_1 patients were observed. Lack of aortic valve opening was associated with progressive AR.

Published
2022

29. Use of Thymol Formulations, Amitraz, and Oxalic Acid for the Control of the Varroa Mite in Honey Bee (Apis mellifera carnica) Colonies

Author

Gregorc Aleš and Planinc Ivo

Subjects
varroa destructor, mite control, apiguard, thymovar, oxalic acid, amitraz., zwalczanie, kwas szczawiowy, amitraza., Zoology, QL1-991
Abstract

Celem pracy było porównanie skuteczności zwalczania roztoczy Varroa destructor za pomocą tymolu, amitrazy oraz kwasu szczawiowego w rodzinach pszczelich z czerwiem. Badania wykonano w pasiekach zlokalizowanych w miejscowości Senično i Bohinj (położonych w strefie klimatu kontynentalnego) oraz w miejscowości Vipava (położonej w strefie klimatu śródziemnomorskiego) na Słowenii. Do zwalczania pasożyta zastosowano Thymovar (Andermatt BioVet AG); Apiguard (Vita Europe Ltd., UK); 12,5% roztwór amitrazy w formie odymiania oraz wodny roztwór kwasu szczawiowego, zawierający 2,9% kwasu szczawiowego i 31,9% cukru. Po wykonaniu zabiegów leczniczych, we wszystkich rodzinach stwierdzono istotny wzrost śmiertelności roztoczy (p

Published
2012
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30. Hereditary transthyretin amyloidosis - in the context of liver transplantation

Author

Knez, Nora, Kulaš, Marjan, Kukić, Sandro, Planinc, Ivo, and Mrzljak, Anna

Subjects
amyloidosis, liver transplant
Abstract

Introduction hereditary transthyretin amyloidosis (hATTR) is a rare progressive autosomal-dominant disorder of protein metabolism caused by the mutated transthyretin (TTR) gene. It is a systemic disease with a variable phenotype due to the more than 100 different mutations in the TTR gene, the Val30Met variant being by far the most common. Amyloidogenic forms of TTR are insoluble aggregated fibrils, accumulated in the extracellular matrix, resulting in morphological and functional impairment. Most commonly hATTR is associated with sensorimotor peripheral neuropathy, autonomic dysfunction, and impaired cardiac function. Other organs that are often affected include the kidneys, eyes, and gastrointestinal tract. Hepatocytes synthesize 98% of TTR, and liver transplantation (LT) has been considered as a treatment option. Case report We present a case of a 56-years-old male patient who underwent LT in July 2022. His family history was positive for hATTR ; the diagnosis was confirmed in 2017 with a subcutaneous fat biopsy and genetic testing that showed Asp38Glu mutation. His past medical history revealed a heart transplant in May 2019 due to restrictive cardiomyopathy, peripheral sensorimotor neuropathy, parasympathetic autonomic dysfunction, and chronic kidney disease. LT postoperative course was unremarkable, and his immunosuppression consisted of steroids, mycophenolate mofetil, and tacrolimus. His short-term follow-up is unremarkable. Discussion/Conclusion In the case of hATTR, LT is implemented as a disease- modifying therapy hoping to slow disease progression in the future. A longer follow-up is needed to demonstrate the benefit of LT. However, potential short- and long-term transplant-related complications direct a need for better treatment options.

Published
2022

32. Penicillium brevicompactum as a causative agent of the central nervous system infection in an immunocompromised patent

Author

Tomasović, Domagoj, Juraj, Krznarić, Gjurašin, Branimir, Marinković, Luka, Bilić, Jaka, Čičmak, Ana, Marjanović, Marcel, Marasanov Kavanagh, Sergej, Višković, Klaudija, Župetić, Ivana, Planinc, Ivo, Kutleša, Marko, and Santini, Marija

Subjects
central nervous system (CNS) infection, Penicillium brevicompactum
Abstract

Objectives: To present a case of the central nervous system (CNS) infection caused by Penicillium brevicompactum in an immunocompromised patient. Case Report: A 63-year-old male patient with a history of heart transplantation was treated for COVID-19 at the University Hospital Centre Zagreb (UHCZ) in June 2021. During this hospitalization, he developed ethmoid and sphenoid sinusitis. His immunosuppression was modified (cyclosporine and tacrolimus stopped, prednisolone dose elevated), and voriconazole was administered. The patient deteriorated by developing fever, somnolence, vertigo, ataxia, diplopia and dysphagia. Brain MR revealed bitemporal corticosubcortical lesions, ischaemic lesion in the pons, and pansinusitis. Cerebrospinal fluid (CSF) analysis demonstrated mild pleocytosis with neutrophilia, normal glucose and protein, but elevated lactate level. The patient was transferred to the University Hospital for Infectious Diseases, Zagreb, Croatia. Broad microbiological tests performed on CSF did not yield causative agents. Empirical therapy with liposomal amphotericin B, meropenem and vancomycin was initiated. The patient's condition further deteriorated. A brain biopsy was performed, and it revealed fungal hyphae. A combination of liposomal amphotericin B and isavuconazole was continued. Penicillium brevicompactum was isolated from the biopsy sample. Endoscopic ethmoid and sphenoid sinus operation was performed in order to control the possible source of infection. Antifungal therapy combined with sinus surgery resulted in body temperature normalization, weaning from mechanical ventilation, the patient spontaneously opening his left eye, having right-sided ptosis with mydriasis, and tetraplegia. Conclusion: In immunocompromised patients with CNS infections, we can expect rare pathogens, challenging to detect. As a last resort, a brain biopsy could be considered in this subpopulation of patients (when all other options have been exausted), which may lead to exact diagnosis and targeted timely antimicrobial therapy.

Published
2021

33. Improved survival of left ventricular assist device carriers in Europe according to implantation eras: results from the PCHF‐VAD registry.

Author

Jakus, Nina, Brugts, Jasper J., Claggett, Brian, Timmermans, Philippe, Pouleur, Anne‐Catherine, Rubiś, Pawel, Van Craenenbroeck, Emeline M., Gaizauskas, Edvinas, Barge‐Caballero, Eduardo, Paolillo, Stefania, Grundmann, Sebastian, D'Amario, Domenico, Braun, Oscar Ö., Gkouziouta, Aggeliki, Meyns, Bart, Droogne, Walter, Wierzbicki, Karol, Holcman, Katarzyna, Planinc, Ivo, and Skoric, Bosko

Abstract

Aims: Temporal changes in patient selection and major technological developments have occurred in the field of left ventricular assist devices (LVADs), yet analyses depicting this trend are lacking for Europe. We describe the advances of European LVAD programmes from the PCHF‐VAD registry across device implantation eras. Methods and results: Of 583 patients from 13 European centres in the registry, 556 patients (mean age 53 ± 12 years, 82% male) were eligible for this analysis. Patients were divided into eras (E) by date of LVAD implantation: E1 from December 2006 to December 2012 (6 years), E2 from January 2013 to January 2020 (7 years). Patients implanted more recently were older with more comorbidities, but less acutely ill. Receiving an LVAD in E2 was associated with improved 1‐year survival in adjusted analysis (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.35–0.98; p = 0.043). LVAD implantation in E2 was associated with a significantly lower chance of heart transplantation (adjusted HR 0.40, 95% CI 0.23–0.67; p = 0.001), and lower risk of LVAD‐related infections (adjusted HR 0.64, 95% CI 0.43–0.95; p = 0.027), both in unadjusted and adjusted analyses. The adjusted risk of haemocompatibility‐related events decreased (HR 0.60, 95% CI 0.39–0.91; p = 0.016), while heart failure‐related events increased in E2 (HR 1.67, 95% CI 1.02–2.75; p = 0.043). Conclusion: In an analysis depicting the evolving landscape of continuous‐flow LVAD carriers in Europe over 13 years, a trend towards better survival was seen in recent years, despite older recipients with more comorbidities, potentially attributable to increasing expertise of LVAD centres, improved patient selection and pump technology. However, a smaller chance of undergoing heart transplantation was noted in the second era, underscoring the relevance of improved outcomes on LVAD support. [ABSTRACT FROM AUTHOR]

Published
2022
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34. Myocardial Remodeling in Ischemic Heart Disease – Imaging from Cell to Organ Level by Synchrotron Propagation Based X-Ray Phase-Contrast Imaging

Author

Planinc, Ivo, primary, Garcia-Canadilla, Patricia, additional, Dejea, Hector, additional, Ilic, Ivana, additional, Guasch, Eduard, additional, Zamora, Monica, additional, Crispi, Fatima, additional, Stampanoni, Marco, additional, Milicic, Davor, additional, Bijnens, Bart, additional, Bonnin, Anne, additional, and Cikes, Maja, additional

Published
2021
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36. Left ventricular unloading using a percutaneous paracorporeal left ventricular assist device – University Hospital Centre Zagreb experience

Author

Šipuš, Dubravka, primary, Planinc, Ivo, additional, Skorić, Boško, additional, Velagić, Vedran, additional, Pašalić, Marijan, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Samardžić, Jure, additional, Ljubas Maček, Jana, additional, Gašparović, Hrvoje, additional, Biočina, Bojan, additional, Miličić, Davor, additional, and Čikeš, Maja, additional

Published
2021
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37. Pregnancy in a post-cardiac transplant patient

Author

Dubravčić, Mia, primary, Čikeš, Maja, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Samardžić, Jure, additional, Ljubas Maček, Jana, additional, Planinc, Ivo, additional, Pašalić, Marijan, additional, Jakuš, Nina, additional, Fabijanović, Dora, additional, Miličić, Davor, additional, and Skorić, Boško, additional

Published
2021
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38. Ten years of extracorporeal membrane oxygenation support at University Hospital Centre Zagreb

Author

Dubravčić, Mia, primary, Šipuš, Dubravka, additional, Fabijanović, Dora, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Samardžić, Jure, additional, Ljubas Maček, Jana, additional, Planinc, Ivo, additional, Pašalić, Marijan, additional, Jakuš, Nina, additional, Čikeš, Maja, additional, Miličić, Davor, additional, and Skorić, Boško, additional

Published
2021
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39. COVID-19 in heart transplant recipients

Author

Mjehović, Petra, primary, Čikeš, Maja, additional, Dubravčić, Mia, additional, Fabijanović, Dora, additional, Jakuš, Nina, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Ljubas Maček, Jana, additional, Pašalić, Marijan, additional, Planinc, Ivo, additional, Samardžić, Jure, additional, Skorić, Boško, additional, and Miličić, Davor, additional

Published
2021
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40. Genetics in the advanced heart failure population – University Hospital Centre Zagreb experience

Author

Planinc, Ivo, primary, Šipuš, Dubravka, additional, Jakuš, Nina, additional, Fabijanović, Dora, additional, Skorić, Boško, additional, Jurin, Hrvoje, additional, Samardžić, Jure, additional, Ljubas, Jana, additional, Pašalić, Marijan, additional, Lovrić, Daniel, additional, Borovečki, Fran, additional, Čikeš, Maja, additional, and Miličić, Davor, additional

Published
2021
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42. Paracorporeal right ventricular assist device for acute and chronic right heart failure in carriers of durable left ventricular assist devices

Author

Šipuš, Dubravka, primary, Planinc, Ivo, additional, Skorić, Boško, additional, Pašalić, Marijan, additional, Jurin, Hrvoje, additional, Lovrić, Daniel, additional, Samardžić, Jure, additional, Ljubas Maček, Jana, additional, Gašparović, Hrvoje, additional, Biočina, Bojan, additional, Miličić, Davor, additional, and Čikeš, Maja, additional

Published
2021
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46. Detection of early cardiac allograft vasculopathy in a high-risk transplant patient using optical coherence tomography

Author

Skorić, Boško, primary, Bulum, Joško, additional, Jurin, Hrvoje, additional, Marić Bešić, Kristina, additional, Čikeš, Maja, additional, Planinc, Ivo, additional, Dubravčić, Mia, additional, Šipuš, Dubravka, additional, Žunec, Renata, additional, Burek Kamenarić, Marija, additional, and Miličić, Davor, additional

Published
2020
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47. Freeze or burn – platelets do not seem to care! Results from the SPARELIFE-CVD substudy.

Author

Samardžić, Petar, Rudelj, Laura, Planinc, Ivo, Jurin, Hrvoje, Velagić, Vedran, Čikeš, Maja, Skorić, Boško, Puljević, Davor, Samardžić, Jure, and Miličić, Davor

Subjects
CRYOSURGERY, BLOOD platelets, THROMBIN receptors, PULMONARY veins, ADENOSINE diphosphate, ATRIAL fibrillation, BURN care units
Abstract

Introduction: Pulmonary vein isolation (PVI) is an established procedure to treat atrial fibrillation (Afib) but it increases periinterventional thromboembolic burden¹ . Literature provides ambiguous results about ablation effects on different hemostatic markers. The aim of this study was to assess the difference between two used PVI methods (cryoablation and radiofrequency ablation (RFA)) in postinterventional platelet reactivity (PR). Patients and Methods: We analyzed PR in 168 consecutive patients undergoing PVI due to Afib in our institution using Multiplate function analyzer. Blood samples for PR measurements were drawn prior to the procedure and the on the following morning. In total, 123 and 45 patients underwent cryoablation and RFA, respectively. There was no difference in demographics and baseline platelet parameters between the groups (Table 1). ASPItest, ADPtest and TRAPtest were used as assays for the quantitative in vitro determination of PR triggered by arachidonic acid, adenosine diphosphate and thrombin receptor activating peptide-6, respectively. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Pregnancy in a heart transplant recipient with history of severe humoral and cellular rejection and positive donor-specific antibodies – case report.

Author

Šipuš, Dubravka, Dubravčić, Mia, Došen, Mjehović, Petra, Fabijanović, Dora, Jakuš, Nina, Planinc, Ivo, Pašalić, Marijan, Jurin, Hrvoje, Samardžić, Jure, Lovrić, Daniel, Čikeš, Maja, Gašparović, Hrvoje, Žunec, Renata, Miličić, Davor, Elveđi, Vesna, Gašparović, and Skorić, Boško

Subjects
HEART transplant recipients, UNPLANNED pregnancy, ARTIFICIAL blood circulation, HEART failure, PREGNANCY, MAJOR histocompatibility complex
Abstract

Background: Pregnancy in heart transplant (HT) recipients with episodes of rejection or positive donor specific antibodies (DSA) is discouraged by all recommendations due to higher risk of complications. Although there is paucity of data for DSA trend during pregnancy in HT recipients, there is evidence of improvement of symptoms during pregnancy in some autoimmune diseases1-3. Case report: 23-year-old female who underwent HT due to post-myocarditis cardiomyopathy in June 2014, reported unplanned pregnancy in June 2022. She had a history of acute cellular (3R/3B) and humoral rejection (DSA major histocompatibility complex (HLA) class I, specificity A11, A30, B13, B35 and HLA class II, specificity DR3, DR15, DR51, DR52, DQ2, mean fluorescent intensity (MFI) 1000-13 300) in August 2017 which required mechanical circulatory support due to severe heart failure with multiorgan damage. She underwent pulse corticosteroid treatment, and 12 cycles of plasmapheresis with administration of rituximab, intravenous immunoglobulins, and thymoglobulin. After that she had persistent positive DSA, predominantly DQ2 (MFI up to 12200), and because of that was on quadruple immunosuppression (tacrolimus, mycophenolate (MMF), everolimus, prednisone) from October 2019 to July 2020 when MMF was discontinued due to gastrointestinal side effects. She had one more cellular rejection episode (2R/3A) in March 2022 which was treated with pulse corticosteroids. During pregnancy she was on tacrolimus, everolimus, and prednisone combination with closely monitoring of immunosuppressants concentrations. Echocardiography controls showed normal left ventricle function and mildly reduced right ventricle function, NT-proBNP was slightly elevated (493-823 ng/L) and DSA were in a downward trend which is shown in Figure 1. At 32+3 weeks of pregnancy, she was hospitalized due to early labor. The following day male baby was delivered by Caesarean section due to pathological cardiotocography (Apgar score 8/9). After delivery DSA remained weakly positive. Conclusion: Although pregnancy in HT recipients with history of rejection and positive DSA is discouraged, positive outcome is possible with close monitoring of multidisciplinary team. Furthermore, we described a rare case of downward trend of positive DSA during pregnancy. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Učinkovitost i sigurnost individualizirane primjene antagonista P2Y12 receptora temeljem agregometrije u odnosu na fiksne doze u bolesnika nakon akutnog infarkta miokarda s elevacijom ST- segmenta

Author

Jurin, Hrvoje, Samardžić, Jure, Pavasović, Saša, Dubravčić, Mia, Pašalić, Marijan, Skorić, Boško, Čikeš, Maja, Lovrić, Daniel, Ljubas Maček, Jana, Fabijanović, Dora, Planinc, Ivo, Jakuš, Nina, and Miličić, Davor

Subjects
antiagregacijska terapija, akutni koronarni sindrom
Abstract

Uvod: Postoji niz studija koje su ukazale na postojanje povišene ostatne trombocitne aktivnosti (mjerene testovima trombocitne agregacije) u pojedinih bolesnika liječenih klopi-dogrelom ovisno o stupnju biotransformacije lijeka.1-3 Također je pokazano kako se povišenjem doze klopidogrela može nadvladati navedena povišena aktivnost, a time ujedno i utjecati na kliničke ishode liječenja. Ovdje donosimo rezultate skupine bolesnika koji su dovršili jednogodišnje praćenje, a koji su uvršteni u randomiziranu kliničku studiju ispitivanja učinkovitosti i sigurnosti individualizirane primjene antago-nista P2Y12 receptora temeljem nalaza testova agregometrije u odnosu na fiksne doze tikagrelora u bolesnika nakon akut-nog infarkta miokarda s elevacijom ST- segmenta (STEMI).Bolesnici i metode: U analizu je uključeno 51 uzastopnih bolesnika (9 žena, srednja dob 58, 9 godina) nakon preboljelog STEMI-a. Svi su bolesnici tijekom prvih mjesec dana liječeni standardnom dozom tikagrelora uz acetilsalicilatnu kiselinu, a potom su randomizirani u dvije skupine. Prva skupina je nastavila postojeću antiagregacijsku terapiju tijekom godine dana, a u drugoj je skupini tikagrelor zamijenjen klopidogre-lom uz individualnu titraciju doze ovisno o nalazima agrego-metrije mjerenih Multiplate® analizatorom. Primarni ishod studije bila je incidencija velikih kardiovaskularnih događaja (kardiovaskularna smrt, infarkt miokarda, moždani udar i ponovna revaskularizacija), a sekundarni učestalost velikih i malih krvarenja definiranih BARC klasifikacijom.Rezultati: Tijekom praćenja nije zabilježen niti jedan prima-rni ishod kao niti jedan slučaj velikog krvarenja. Zabilježena je statistički značajno manja incidencija malih krvarenja u skupini bolesnika liječenih individualiziranom primjenom P2Y12 antagonista (p=0, 027) što odgovara 4, 8 puta većoj šansi razvoja krvarenja u bolesnika liječenih fiksnom do-zom tikagrelora u odnosu na bolesnike liječene individuali-ziranim pristupom (OR 4, 8 ; 95% CI 1.118 to 20.611 ; p=0, 035).Zaključak: Rezultati ukazuju kako bi individualizirana primje-na P2Y12 antagonista mogla predstavljati jednako učinkovitu, a sigurniju opciju liječenja bolesnika nakon preboljelog STE-MI-a u odnosu na terapiju fiksnim dozama tikagrelora.

Published
2018

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