46 results on '"Sabbour H"'
Search Results
2. A wolf in sheep's clothing--aortic stenosis and cardiac amyloidosis: "RAISE"ing awareness in clinical practice.
- Author
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Sabbour, H., Al-Humood, K., Al Taha, Z., Romany, I., Haddadin, H., and Mohty, D.
- Published
- 2024
- Full Text
- View/download PDF
3. Dyslipidaemia and its management in patients with type 2 diabetes across the Middle East and Africa: the PACT-MEA study
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Sabbour, H, primary, Alamuddin, N, additional, Alawadi, F, additional, Alkandari, H, additional, Almahmeed, W, additional, Assaad-Khalil, S H, additional, Cinar, T, additional, Haddad, J, additional, Husemoen, L L N, additional, Lombard, L, additional, Malik, R A, additional, Ngome, M, additional, Salek, S, additional, Yadav, G, additional, and Verma, S, additional
- Published
- 2023
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- View/download PDF
4. Cardioprotective pharmacotherapy in patients with type 2 diabetes across the Middle East and Africa: the PACT-MEA study
- Author
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Verma, S, primary, Alamuddin, N, additional, Alawadi, F, additional, Alkandari, H, additional, Almahmeed, W, additional, Assaad-Khalil, S H, additional, Cinar, T, additional, Haddad, J, additional, Husemoen, L L N, additional, Lombard, L, additional, Malik, R A, additional, Ngome, M, additional, Sabbour, H, additional, Yadav, G, additional, and Salek, S, additional
- Published
- 2023
- Full Text
- View/download PDF
5. "Between Scylla and Charybdis" - Severe Right Ventricular Dysfunction Due to Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and Life Threatening Thrombocytopenia
- Author
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Bodi, G.S., primary, Sabbour, H., additional, and Farha, S.Y., additional
- Published
- 2023
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- View/download PDF
6. Managing thrombotic risk in patients with diabetes
- Author
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Camm, AJ, Sabbour, H, Schnell, O, Summaria, F, and Verma, A
- Subjects
Stroke ,Fibrinolytic Agents ,Risk Factors ,Endocrinology, Diabetes and Metabolism ,Atrial Fibrillation ,Diabetes Mellitus ,Administration, Oral ,Anticoagulants ,Humans ,Thrombosis ,Cardiology and Cardiovascular Medicine - Abstract
It is well known that diabetes is a prominent risk factor for cardiovascular (CV) events. The level of CV risk depends on the type and duration of diabetes, age and additional co-morbidities. Diabetes is an independent risk factor for atrial fibrillation (AF) and is frequently observed in patients with AF, which further increases their risk of stroke associated with this cardiac arrhythmia. Nearly one third of patients with diabetes globally have CV disease (CVD). Additionally, co-morbid AF and coronary artery disease are more frequently observed in patients with diabetes than the general population, further increasing the already high CV risk of these patients. To protect against thromboembolic events in patients with diabetes and AF or established CVD, guidelines recommend optimal CV risk factor control, including oral anticoagulation treatment. However, patients with diabetes exist in a prothrombotic and inflammatory state. Greater clinical benefit may therefore be seen with the use of stronger antithrombotic agents or innovative drug combinations in high-risk patients with diabetes, such as those who have concomitant AF or established CVD. In this review, we discuss CV risk management strategies in patients with diabetes and concomitant vascular disease, stroke prevention regimens in patients with diabetes and AF and how worsening renal function in these patients may complicate these approaches. Accumulating evidence from clinical trials and real-world evidence show a benefit to the administration of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with diabetes and AF.
- Published
- 2022
7. IDF21-0451 Using NT-ProBNP for risk stratification in individuals with diabetes: a retrospective study from a diabetes centre
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Radha, S., Khaled, R., Sabbour, H., and Lessan, N.
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- 2022
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- View/download PDF
8. AB0652 Prevalence of Interstitial lung disease and pulmonary arterial hypertension in systemic sclerosis patients cohort at a rheumatology referral centre in the United Arab Emirates
- Author
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Saleh, K., primary, Khan, N., additional, Ghorab, A., additional, El-Kaissi, M., additional, Mubashir, A., additional, Elarabi, M., additional, Sabbour, H., additional, and Namas, R., additional
- Published
- 2022
- Full Text
- View/download PDF
9. Outcome of Chronic Thromboembolic Pulmonary Hypertension Patients: Experience from a Tertiary Referral Center in the United Arab Emirates
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Saleh, K.M., primary, Khan, N., additional, Dougherty, K., additional, Ghorab, A., additional, Abdalla, S., additional, and Sabbour, H., additional
- Published
- 2022
- Full Text
- View/download PDF
10. Defying challenges: mid-term outcomes of international collaborations for a successful heart transplantation program in the middle east
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Hamour, I.M, primary, Ferrer, R, additional, Atallah, B, additional, Gabra, G, additional, Soliman, M, additional, Sabbour, H, additional, and Bader, F, additional
- Published
- 2020
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- View/download PDF
11. Pulmonary Hypertension in the United Arab Emirates: A Single Site Registry
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Dougherty, K., primary, Silvestre, C., additional, Fernandes, J., additional, Sabbour, H., additional, Mallat, J., additional, and Farha, S., additional
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- 2020
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12. P281 Factors influencing apixaban dosing in the middle east gulf region
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Atallah, B, primary, Alsolh, S, additional, El Nekidy, W, additional, Sabbour, H, additional, Almahmeed, W, additional, and Almuti, K, additional
- Published
- 2020
- Full Text
- View/download PDF
13. The Changing Landscape for Stroke Prevention in AF: Findings From the GLORIA-AF Registry Phase 2
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Huisman, M. V., Rothman, K. J., Paquette, M., Teutsch, C., Diener, H. -C., Dubner, S. J., Halperin, J. L., C. S., Ma, Zint, K., Elsaesser, A., Bartels, D. B., Lip, G. Y. H., Abban, D., Abdul, N., Abelson, M., Ackermann, A., Adams, F., Adams, L., Adragao, P., Ageno, W., Aggarwal, R., Agosti, S., Marin, J. A., Aguilar, F., Aguilar Linares, J. A., Aguinaga, L., Ahmad, Z., Ainsworth, P., Al Ghalayini, K., Al Ismail, S., Alasfar, A., Alawwa, A., Al-Dallow, R., Alderson, L., Alexopoulos, D., Ali, A., Ali, M., Aliyar, P., Al-Joundi, T., Al Mahameed, S., Almassi, H., Almuti, K., Al-Obaidi, M., Alshehri, M., Altmann, U., Alves, A. R., Al-Zoebi, A., Amara, W., Amelot, M., Amjadi, N., Ammirati, F., Andrawis, N., Angoulvant, D., Annoni, G., Ansalone, G., Antonescu, S. A., Ariani, M., Arias, J. C., Armero, S., Arora, R., Arora, C., Ashcraft, W., Aslam, M. S., Astesiano, A., Audouin, P., Augenbraun, C., Aydin, S., Azar, R., Azim, A., Aziz, S., Backes, L. M., Baig, M., Bains, S., Bakbak, A., Baker, S., Bakhtiar, K., Bala, R., Banayan, J., Bandh, S., Bando, S., Banerjee, S., Bank, A., Barbarash, O., Baron, G., Barr, C., Barrera, C., Barton, J., Kes, V. B., Baula, G., Bayeh, H., Bazargani, N., Behrens, S., Bell, A., Benezet-Mazuecos, J., Benhalima, B., Berdague, P., Berg van den, B. J., Bergen van, P. F. M. M., Berngard, E., Bernstein, R., Berrospi, P., Berti, S., Bertomeu, V., Berz, A., Bettencourt, P., Betzu, R., Beyer-Westendorf, J., Bhagwat, R., Black, T., Blanco Ibaceta, J. H., Bloom, S., Blumberg, E., Bo, M., Bockisch, V., Bohmer, E., Bongiorni, M. G., Boriani, G., Bosch, R., Boswijk, D. J., Bott, J., Bottacchi, E., Kalan, M. B., Brandes, A., Bratland, B., Brautigam, D., Breton, N., Brouwers, P. J. A. M., Browne, K., Bruguera, J., Brunehaut, M., Brunschwig, C., Buathier, H., Buhl, A., Bullinga, J., Butcher, K., Cabrera Honorio, J. W., Caccavo, A., Cadinot, D., Cai, S., Calvi, V., Camm, J., Candeias, R., Capo, J., Capucci, A., Cardoso, J. N., Duarte Vera, Y. C., Carlson, B., Carvalho, P., Cary, S., Casanova, R., Casu, G., Cattan, S., Cavallini, C., Cayla, G., Cha, T. J., Cha, K. S., Chaaban, S., Chae, J. K., Challappa, K., Chand, S., Chandrashekar, H., Chang, M., Charbel, P., Chartier, L., Chatterjee, K., Cheema, A., Chen, S. -A., Chevallereau, P., Chiang, F. -T., Chiarella, F., Chih-Chan, L., Cho, Y. K., Choi, D. J., Chouinard, G., Danny, Chow, H. F., Chrysos, D., Chumakova, G., Jose Roberto Chuquiure Valenzuela, E. J., Cieza-Lara, T., Nica, V. C., Ciobotaru, V., Cislowski, D., Citerne, O., Claus, M., Clay, A., Clifford, P., Cohen, S., Cohen, A., Colivicchi, F., Collins, R., Compton, S., Connors, S., Conti, A., Buenostro, G. C., Coodley, G., Cooper, M., Corbett, L., Corey, O., Coronel, J., Corrigan, J., Cotrina Pereyra, R. Y., Cottin, Y., Coutu, B., Cracan, A., Crean, P., Crenshaw, J., Crijns, H. J. G. M., Crump, C., Cucher, F., Cudmore, D., Cui, L., Culp, J., Darius, H., Dary, P., Dascotte, O., Dauber, I., Davee, T., Davies, R., Davis, G., Davy, J. -M., Dayer, M., De La Briolle, A., de Mora, M., De Teresa, E., De Wolf, L., Decoulx, E., Deepak, S., Defaye, P., Del-Carpio Munoz, F., Brkljacic, D. D., Deluche, L., Destrac, S., Deumite, N. J., Di Legge, S., Dibon, O., Diemberger, I., Dillinger, J., Dionisio, P., Naydenov, S., Dotani, I., Dotcheva, E., D'Souza, A., Dubrey, S., Ducrocq, X., Dupljakov, D., Duthinh, V., Dutra, O. P., Dutta, D., Duvilla, N., Dy, J., Dziewas, R., Eaton, C., Eaves, W., Ebinger, M., Eck van, J. W. M., Edwards, T., Egocheaga, I., Ehrlich, C., Eisenberg, S., El Hallak, A., El Jabali, A., El Mahmoud, R., El Shahawy, M., Eldadah, Z., Elghelbazouri, F., Elhag, O., El-Hamdani, M., Elias, D., Ellery, A., El-Sayed, H., Elvan, A., Erickson, B., Espaliat, E., Essandoh, L., Everington, T., Evonich, R., Ezhov, A., Facila, L., Farsad, R., Fayard, M., Fedele, F., Gomes Ferreira, L. G., Ferreira, D., Santos, J. F., Ferrier, A., Finsen, A., First, B., Fisher, R., Floyd, J., Folk, T., Fonseca, C., Fonseca, L., Forman, S., Forsgren, M., Foster, M., Foster, N., Frais, M., Frandsen, B., Frappe, T., Freixa, R., French, W., Freydlin, M., Frickel, S., Fruntelata, A. G., Fujii, S., Fujino, Y., Fukunaga, H., Furukawa, Y., Gabelmann, M., Gabris, M., Gadsboll, N., Galin, P., Galinier, M., Ganim, R., Garcia, R., Quintana, A. G., Gartenlaub, O., Genz, C., Georger, F., Georges, J. -L., Georgeson, S., Ghanbasha, A., Giedrimas, E., Gierba, M., Gillespie, E., Giniger, A., Gkotsis, A., Gmehling, J., Gniot, J., Goethals, P., Goldberg, R., Goldmann, B., Goldscher, D., Golitsyn, S., Gomez Lopez, E. A., Gomez Mesa, J. E., Gonzalez, E., Cocina, E. G., Juanatey, C. G., Gorbunov, V., Gordon, B., Gorka, H., Gornick, C., Gorog, D., Goss, F., Gotte, A., Goube, P., Goudevenos, I., Goulden, D., Graham, B., Grande, A., Greco, C., Green, M., Greer, G., Gremmler, U., Grena, P., Grinshstein, Y., Grond, M., Gronda, E., Grondin, F., Gronefeld, G., Groot de, J. R., Guardigli, G., Guarnieri, T., Caiedo, C. G., Guignier, A., Gulizia, M., Gumbley, M., Gupta, D., Hack, T., Haerer, W., Hakas, J., Hall, C., Hampsey, J., Hananis, G., Hanbali, B., Handel, F., Hargrove, J., Hargroves, D., Harris, K., Hartley, D., Haruna, T., Hata, Y., Hayek, E., Healey, J., Hearne, S., Heggelund, G., Hemels, M. E. W., Hemery, Y., Henein, S., Henz, B., Her, S. -H., Hermany, P., Hernandes, M. E., Higashino, Y., Hill, M., Hisadome, T., Hishida, E., Hitchcock, J., Hoffer, E., Hoghton, M., Holmes, C., Hong, S. K., Houppe Nousse, M. -P., Howard, V., Hsu, L. F., Huang, C. -H., Huckins, D., Huehnergarth, K., Huizenga, A., Huntley, R., Hussein, G., Hwang, G. -S., Igbokidi, O., Iglesias, I., Ikpoh, M., Imberti, D., Ince, H., Indolfi, C., Ionova, T., Ip, J., Irles, D., Iseki, H., Ismail, Y., Israel, N., Isserman, S., Iteld, B., Ivanchura, G., Iyer, R., Iyer, V., Iza Villanueva, R. O., Jackson-Voyzey, E., Jaffrani, N., Jager, F., Jain, M., James, M., Jamon, Y., Jang, S. W., Pereira Jardim, C. A., Jarmukli, N., Jeanfreau, R., Jenkins, R., Jiang, X., Jiang, H., Jiang, T., Jiang, N., Jimenez, J., Jobe, R., Joffe, I., Johansson, B., Jones, N., Moura Jorge, J. C., Jouve, B., Jundi, M., Jung, W., Jung, B. C., Jung, K. T., Kabbani, S., Kabour, A., Kafkala, C., Kajiwara, K., Kalinina, L., Kampus, P., Kanda, J., Kapadia, S., Karim, A., Karolyi, L., Kashou, H., Kastrup, A., Katsivas, A., Kaufman, E., Kawai, K., Kawajiri, K., Kazmierski, J., Keeling, P., Kerfes, G. A., Kerr Saraiva, J. F., Ketova, G., Khaira, A., Khalid, M., Khludeeva, E., Khripun, A., Kim, D. I., Kim, D. K., Kim, N. H., Kim, K. S., Kim, Y. -H., Kim, J. B., Kim, J. S., Kinova, E., Klein, A., Kleinschnitz, C., Kmetzo, J., Kneller, G. L., Knezevic, A., Koch, S., Koenig, K., Angela Koh, S. M., Kohrmann, M., Koons, J., Korabathina, R., Korennova, O., Koschutnik, M., Kosinski, E., Kovacic, D., Kowalczyk, J., Koziolova, N., Kragten, J. A., Krause, L. U., Kreidieh, I., Krenning, B. J., Krishnaswamy, K., Krysiak, W., Kuck, K. -H., Kumar, S., Kumler, T., Kuniss, M., Kuo, J. -Y., Kuppers, A., Kurrelmeyer, K., Kwan, T., Kyo, E., Labovitz, A., Lacroix, A., Lam, A., Lanas Zanetti, F. T., Landau, C., Landini, G., Lang, W., Larsen, T. B., Laske, V., Lavandier, K., Law, N., Lee, M. H., Lee, D., Leitao, A., Lejay, D., Lelonek, M., Lenarczyk, R., Leprince, P., Lequeux, B., Leschke, M., Ley, N., Li, Z., Li, Y., Li, X., Li, W., Liang, J., Lieber, I., Lillestol, M., Limon Rodriguez, R. H., Lin, H., Lip, G., Litchfield, J., Liu, Z., Liu, X., Liu, Y., Liu, F., Liu, W., Llamas Esperon, G. A., Llisterri, J. L., Lo, T., Lo, E., Lobos, J. M., Lodde, B. -P., Loiselet, P., Lopez-Sendon, J., Lorga Filho, A. M., Lori, I., Luo, M., Lupovitch, S., Lyrer, P., Zuhairy, H. M., Ma, C., Ma, G., Ma, H., Madariaga, I., Maeno, K., Magnin, D., Mahmood, S., Mahood, K., Maid, G., Mainigi, S., Makaritsis, K., Maldonado Villalon, J. A., Malhotra, R., Malik, A., Mallecourt, C., Mallik, R., Manning, R., Manolis, A., Mantas, I., Manzur Jattin, F. G., Marcionni, N., Marin, F., Santana, A. M., Martinez, J., Martinez, L., Maskova, P., Hernandez, N. M., Matskeplishvili, S., Matsuda, K., Mavri, A., May, E., Mayer, N., Mazon, P., Mcclure, J., Mccormack, T., Mcgarity, W., Mcguire, M., Mcintyre, H., Mclaughlin, P., Mclaurin, B., Medina Palomino, F. A., Mehta, P., Mehzad, R., Meinel, A., Melandri, F., Mena, A., Meno, H., Menzies, D., Metcalf, K., Meyer, B., Miarka, J., Mibach, F., Michalski, D., Michel, P., Chreih, R. M., Mikdadi, G., Mikhail, M., Mikus, M., Milicic, D., Militaru, C., Miller, G., Milonas, C., Minescu, B., Mintale, I., Miralles, A., Mirault, T., Mistry, D., Mitchell, G., Miu, N. V., Miyamoto, N., Moccetti, T., Mohammed, A., Nor, A. M., Molina de Salazar, D. I., Molon, G., Molony, D., Mondillo, S., Mont, L., Moodley, R., Moore, R., Ribeiro Moreira, D. A., Mori, K., Moriarty, A., Morka, J., Moschos, N., Mota Gomes, M. A., Mousallem, N., Moya, A., Mugge, A., Mulhearn, T., Muller, J. -J., Muresan, C. M., Muse, D., Musial, W., Musumeci, F., Nadar, V., Nageh, T., Nair, P., Nakagawa, H., Nakamura, Y., Nakayama, T., Nam, K. -B., Napalkov, D., Natarajan, I., Nayak, H., Nechvatal, L., Neiman, J., Nerheim, P., Neuenschwander, F. C., Nishida, K., Nizov, A., Novikova, T., Novo, S., Nowalany-Kozielska, E., Nsah, E., Nunez Fragoso, J. C., Nyvad, O., de Los Rios Ibarra, M. O., O'Donnell, M., O'Donnell, P., D. J., Oh, Y. S., Oh, Daniel Oh, C. T., O'Hara, G., Oikonomou, K., Olalla, J. J., Olivari, Z., Oliver, R., Olympios, C., Osborne, J., Osca, J., Osman, R., Osunkoya, A., Padanilam, B., Panchenko, E., Pandey, A. S., Vicenzo de Paola, A. A., Paraschos, A., Pardell, H., Park, H. W., Park, J. S., Parkash, R., Parker, I., Parrens, E., Parris, R., Passamonti, E., Patel, J., Patel, R., Pentz, W. H., Persic, V., Perticone, F., Peters, P., Petkar, S., Pezo, L. F., Pham, D., Cao Phai, G. P., Phlaum, S., Pineau, J., Pineda-Velez, A., Pini, R., Pinter, A., Pinto, F., Pirelli, S., Pivac, N., Pizzini, A. M., Pocanic, D., Calin Podoleanu, C. G., Polanczyk, C. A., Polasek, P., Poljakovic, Z., Pollock, S., Polo, J., Poock, J., Poppert, H., Porro, Y., Pose, A., Poulain, F., Poulard, J. -E., Pouzar, J., Povolny, P., Pozzer, D., Pras, A., Prasad, N., Prevot, S., Protasov, K., Prunier, L., Puleo, J., Pye, M., Qaddoura, F., Quedillac, J. -M., Raev, D., Rahimi, S., Raisaro, A., Rama, B., Ranadive, N., Randall, K., Ranjith, N., Raposo, N., Rashid, H., Raters, C., Rauch-Kroehnert, U., Rebane, T., Regner, S., Renzi, M., Reyes Rocha, M. A., Reza, S., Ria, L., Richter, D., Rickli, H., Rickner, K., Rieker, W., Rigo, F., Ripoll, T., Fonteles Ritt, L. E., Roberts, D., Pascual, C. R., Briones, I. R., Reyes, H. R., Roelke, M., Roman, M., Romeo, F., Ronner, E., Ronziere, T., Rooyer, F. A., Rosenbaum, D., Roth, S., Rozkova, N., Rubacek, M., Rubalcava, F., Rubanenko, O., Rubin, A., Borret, M. R., Rybak, K., Sabbour, H., Morales, O. S., Sakai, T., Salacata, A., Salecker, I., Salem, A., Salfity, M., Salguero, R., Salvioni, A., Samson, M., Sanchez, G., Sandesara, C., Saporito, W. F., Sasaoka, T., Sattar, P., Savard, D., Scala, P. -J., Scemama, J., Schaupp, T., Schellinger, P., Scherr, C., Schmitz, K. -H., Schmitz, B., Schmitz, L., Schnitzler, R., Schnupp, S., Schoeniger, P., Schon, N., Schuster, S., Schwimmbeck, P., Seamark, C., Seebass, R., Seidl, K. -H., Seidman, B., Sek, J., Sekaran, L., Seko, Y., Sepulveda Varela, P. A., Sevilla, B., Shah, V., Shah, A., Shah, N., Shanes, J., Sharareh, A., Sharma, V. K., Shaw, L., Shimizu, Y., Shimomura, H., Shin, D. G., Shin, E. -S., Shite, J., Shoukfeh, M., Shoultz, C., Silver, F., Sime, I., Simmers, T. A., Singal, D., Singh, N., Siostrzonek, P., Sirajuddin, M., Skeppholm, M., Smadja, D., Smith, R., Smith, D., Soda, H., Sofley, C. W., Sokal, A., Sotolongo, R., de Souza, O. F., Sparby, J. A., Spinar, J., Sprigings, D., Spyropoulos, A., Stakos, D., Steinberg, A., Steinwender, C., Stergiou, G., Stites, H. W., Stoikov, A., Strasser, R., Streb, W., Styliadis, I., Su, G., Su, X., Suarez, R. M., Sudnik, W., Sueyoshi, A., Sukles, K., Sun, L., Suneja, R., Svensson, P., Ziekenhuis, A., Szavits-Nossan, J., Taggeselle, J., Takagi, Y., Takhar, A., Tallet, J., Tamm, A., Tanaka, S., Tanaka, K., Tang, A., Tang, S., Tassinari, T., Tayama, S., Tayebjee, M., Tebbe, U., Teixeira, J., Tesloianu, D. N., Tessier, P., The, S. H. K., Thevenin, J., Thomas, H., Timsit, S., Topkis, R., Torosoff, M., Touze, E., Traissac, T., Trendafilova, E., Troyan, B., Tsai, W. K., Tse, H. F., Tsutsui, H., Tsutsui, T., Tuininga, Y. S., Turakhia, M., Turk, S., Turner, W., Tveit, A., Twiddy, S., Tytus, R., Ukrainski, G., Valdovinos Chavez, S. B., Van De Graaff, E., Vanacker, P., Vardas, P., Vargas, M., Vassilikos, V., Vazquez, J., Venkataraman, A., Verdecchia, P., Vester, E. G., Vial, H., Vinereanu, D., Vlastaris, A., Vogel, C., vom Dahl, J., von Mering, M., Vora, K., Wakefield, P., Walia, J., Walter, T., Wang, M., Wang, N., Wang, F., Wang, X., Wang, Z., Wang, K. -Y., Watanabe, K., Wei, J., Weimar, C., Weinrich, R., Wen, M. -S., Wheelan, K., Wicke, J., Wiemer, M., Wild, B., Wilke, A., Willems, S., Williams, M., Williams, D., Winkler, A., Wirtz, J. H., Witzenbichler, B., Wong, D. H. K., Lawrence Wong, K. S., Wong, B., Wozakowska-Kaplon, B., Wu, Z., Wu, S., Wyatt, N., Xu, Y., Xu, X., Yamada, A., Yamamoto, K., Yamanoue, H., Yamashita, T., Bryan Yan, P. Y., Yang, Y., Yang, T., Yao, J., Yarlagadda, C., Yeh, K. -H., Yotov, Y., Yvorra, S., Zahn, R., Zamorano, J., Zanini, R., Zarich, S., Zebrack, J., Zenin, S., Zeuthen, E. L., Zhang, X., Zhang, Q., Zhang, D., Zhang, H., Zhao, S., Zhao, X., Zheng, Y., Zheng, Q., Zhou, J., Zimmermann, S. L., Zimmermann, R., Zukerman, L. S., Zwaan van der, C., Huisman, M, Rothman, K, Paquette, M, Teutsch, C, Diener, H, Dubner, S, Halperin, J, Ma, C, Zint, K, Elsaesser, A, Bartels, D, Lip, G, Abban, D, Abdul, N, Abelson, M, Ackermann, A, Adams, F, Adams, L, Adragão, P, Ageno, W, Aggarwal, R, Agosti, S, Marin, J, Aguilar, F, Aguilar Linares, J, Aguinaga, L, Ahmad, Z, Ainsworth, P, Al Ghalayini, K, Al Ismail, S, Alasfar, A, Alawwa, A, Al Dallow, R, Alderson, L, Alexopoulos, D, Ali, A, Ali, M, Aliyar, P, Al Joundi, T, Al Mahameed, S, Almassi, H, Almuti, K, Al Obaidi, M, Alshehri, M, Altmann, U, Alves, A, Al Zoebi, A, Amara, W, Amelot, M, Amjadi, N, Ammirati, F, Andrawis, N, Angoulvant, D, Annoni, G, Ansalone, G, Antonescu, S, Ariani, M, Arias, J, Armero, S, Arora, R, Arora, C, Ashcraft, W, Aslam, M, Astesiano, A, Audouin, P, Augenbraun, C, Aydin, S, Azar, R, Azim, A, Aziz, S, Backes, L, Baig, M, Bains, S, Bakbak, A, Baker, S, Bakhtiar, K, Bala, R, Banayan, J, Bandh, S, Bando, S, Banerjee, S, Bank, A, Barbarash, O, Barón, 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J, Zimmermann, S, Zimmermann, R, Zukerman, L, and Zwaan van der, C
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Male ,oral anticoagulation ,Internationality ,Middle Aged ,registry ,Antithrombins ,Dabigatran ,Stroke ,Cross-Sectional Studies ,Fibrinolytic Agents ,Humans ,Female ,atrial fibrillation ,Prospective Studies ,Registries ,Cardiology and Cardiovascular Medicine ,Aged ,Atrial Fibrillation - Abstract
Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non–vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients’ baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score ≥2; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701)
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- 2017
14. The Changing Landscape for Stroke Prevention in AF: Findings From the GLORIA-AF Registry Phase 2
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Huisman, M, Rothman, K, Paquette, M, Teutsch, C, Diener, H, Dubner, S, Halperin, J, Ma, C, Zint, K, Elsaesser, A, Bartels, D, Lip, G, Abban, D, Abdul, N, Abelson, M, Ackermann, A, Adams, F, Adams, L, Adragão, P, Ageno, W, Aggarwal, R, Agosti, S, Marin, J, Aguilar, F, Aguilar Linares, J, Aguinaga, L, Ahmad, Z, Ainsworth, P, Al Ghalayini, K, Al Ismail, S, Alasfar, A, Alawwa, A, Al Dallow, R, Alderson, L, Alexopoulos, D, Ali, A, Ali, M, Aliyar, P, Al Joundi, T, Al Mahameed, S, Almassi, H, Almuti, K, Al Obaidi, M, Alshehri, M, Altmann, U, Alves, A, Al Zoebi, A, Amara, W, Amelot, M, Amjadi, N, Ammirati, F, Andrawis, N, Angoulvant, D, Annoni, G, Ansalone, G, Antonescu, S, Ariani, M, Arias, J, Armero, S, Arora, R, Arora, C, Ashcraft, W, Aslam, M, Astesiano, A, Audouin, P, Augenbraun, C, Aydin, S, Azar, R, Azim, A, Aziz, S, Backes, L, Baig, M, Bains, S, Bakbak, A, Baker, S, Bakhtiar, K, Bala, R, Banayan, J, Bandh, S, Bando, S, Banerjee, S, Bank, A, Barbarash, O, Barón, G, Barr, C, Barrera, C, 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Zhang, H, Zhao, S, Zhao, X, Zheng, Y, Zheng, Q, Zhou, J, Zimmermann, S, Zimmermann, R, Zukerman, L, Zwaan van der, C, Zwaan van der, C., and ANNONI, GIORGIO
- Abstract
Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non–vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients’ baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score ≥2; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients rece
- Published
- 2017
15. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)
- Author
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Jie Lin, Snejana Tisheva, Ishwar C. Verma, Francesco Cipollone, Liam R. Brunham, Florentina Predica, Perla A.C. Gonzalez, Jocelyne Inamo, André R. Miserez, Belma Pojskic, Michel Farnier, Avishay Ellis, Katia Bonomo, Ibrahim Al-Zakwani, Maria Grazia Zenti, Humberto A. Lopez, Khairul Shafiq Ibrahim, Erkin M. Mirrakhimov, Alexey Meshkov, Jose P. de Moura, Muthukkaruppan Annamalai, Raul D. Santos, F. Paillard, Maria Del Ben, Jan Lacko, Miguel T. Rico, Ximena Reyes, Laura E.G. de Leon, Noor Shafina Mohd Nor, Ulrich Julius, Mohammed A. Batais, Dieter Böhm, Ta-Chen Su, Takuya Kobayashi, Magdalena Chmara, Marco Gebauer, Marcos M. Lima-Martínez, Ravshanbek D. Kurbanov, Daisaku Masuda, Amro El-Hadidy, Melanie Schüler, Francisco Fuentes, Florian J. Mayer, Helena Vaverkova, F. Ulrich Beil, Juraj Bujdak, Mario Stoll, Isabelle Ruel, Elena Dorn, Thomas M. Stulnig, Abubaker Elfatih, Rano B. Alieva, Jiri Vesely, Valérie Carreau, Cristina M. Sibaja, Sophie Béliard, Olivier Ziegler, Adriana Branchi, Daniel Schurr, G.B. John Mancini, Tai E. Shyong, Eric L.T. Siang, Mafalda Bourbon, Zerrin Yigit, Meral Kayıkçıoğlu, Jacques Genest, Wei Yu, Michal Vrablík, Shavkat U. Hoshimov, Dan Gaita, Antonio Pipolo, Ashraf H.A. AlQudaimi, Walter Speidl, Gianfranco Parati, Zaliha Ismail, Victoria M. Zubieta, René Valéro, Tomas Salek, Hana Halamkova, Gustavs Latkovskis, Nicole Allendorf-Ostwald, Agnes Perrin, Vladimir Soska, Anastasia Garoufi, Francisco Araujo, Nacu C. Portilla, Thomas Segiet, Charalambos Koumaras, Hila Knobler, Fatih Sivri, Hani Altaradi, Ivan Pećin, Long Jiang, Alexander Dressel, Marlena Woś, Jana Franekova, D. Agapakis, Quitéria Rato, Dirk J. Blom, Marcin A. Bartlomiejczyk, Krzysztof Dyrbuś, Maurizio Averna, Phivos Symeonides, Yung A. Chua, Asim Rana, András Nagy, Juan C.G. Cuellar, Alexander Jäkel, Maya Safarova, Neama Luqman, Amalia-Despoina Koutsogianni, Patrick Tounian, Jose A. 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Jamal, Vaclava Palanova, Giacomo Biasucci, Pucong Ye, Eva Cubova, Roopa Mehta, Rüdiger Schweizer, Veronica Zampoleri, Jacek Jóźwiak, Alyaa Al-Khateeb, Jing Hong, Katarina Raslova, Kirsten B. Holven, Tatiana Rozkova, Reinhold Busch, Alexander Klabnik, Konrad Hein, Eloy A.Z. Carrillo, Robin Urbanek, Livia Pisciotta, Fatma Y. Coskun, Jose J.G. Garcia, Valerio Pecchioli, Azra D. Nalbantic, Weerapan Khovidhunkit, Jernej Kovac, Michaela Kadurova, Mohammed Al-Jarallah, Vita Saripo, Christos V. Rizos, Jie Peng, Ang L. Chua, Dorothee Deiss, Nor A.A. Murad, Aneta Stróżyk, See Kwok, Gökhan Alici, Gillian J. Pilcher, John J.P. Kastelein, Dmitry Duplyakov, Calin Lengher, Milena Budikova, C. Azzopardi, Christina Antza, Luis E.V. Arroyo, Khalid Al-Jumaily, Ahmad Al-Sarraf, Carlos A. Aguilar-Salinas, Erkayim Bektasheva, Arta Upena-RozeMicena, Qian Wang, Xumin Wang, Leah Leavit, Radzi Rahmat, Selim Topcu, Željko Reiner, Lorenzo Maroni, Matija Cevc, Elizabeth R. Cooremans, Masatsune Ogura, Tevfik Sabuncu, Ruy D Arjona Villicaña, Andrea Giaccari, Xuesong Fan, Auryan Szalat, Sanjaya Dissanayake, Etienne Khoury, Anja Vogt, Hermann Toplak, Alexis Baass, Isabel Palma, Gaelle Sablon, Dana A. Hay, Ya Yang, Margus Viigimaa, Erik S.G. Stroes, Dror Harats, Konstantin Krychtiuk, Zesen Liu, Aleksandra Parczewska, Yves Cottin, Yichen Qu, Mathilde Di-Fillipo, Agnieszka Konopka, Lamija Pojskic, Guadalupe J. Dominguez, Ahmet Temizhan, Roberto C. Chacon, Ibrahim E. Dural, Qiang Yong, G. Kees Hovingh, Kang Meng, Sandra Kutkiene, Julie Lemale, Reinhold Innerhofer, Alexandros D. Tselepis, Handrean Soran, Wolfgang König, Bassam Atallah, Olena Mitchenko, Jana Cepova, Eduardo M. Rodriguez, Ulrich Laufs, Norhidayah Rosman, Alena Lubasova, V. Durlach, Frederick J. Raal, Elyor Khodzhiboboev, Cristina Pederiva, Hui Yuan, Ashraf Reda, Fahad Alnouri, Konstantinos Tziomalos, Thanh T. Le, Jana Sirotiakova, Régis Hankard, Hector E.A. Cazares, Betsabel Rodriguez, Lenka Pavlickova, Assen Goudev, Julius Katzmann, Diana Boger, Wael Almahmeed, Katarina T. Podkrajsek, Sabina Zambon, Fahri Bayram, Nadia Citroni, Samir Rafla, Vincent Rigalleau, Aleksandr B. Shek, Hani Sabbour, Berenice G. Guzman, Shoshi Shpitzen, Eric Tarantino, Ahmed Bendary, Fedya Nikolov, Jean Bergeron, Stefan Kopf, Iva Rasulic, Gerald F. Watts, Muhammad I.A. Hafidz, Mehmet B. Yilmaz, Kathrin Biolik, Ira A. Haack, Robert A. Hegele, Sonia Dulong, Bartosz Wasąg, Osama Sanad, Susana Correia, Zhenjia Wang, Dana Biedermann, Christel König, Helena Podzimkova, Ihab Daoud, Mohammad Alghamdi, Dražen Perica, László Márk, Iosif Koutagiar, Volkan Dogan, Vladimir Blaha, Chandrashekhar K. Ponde, Katerina Valoskova, Amer A. Jabbar, Azhari Rosman, Sazzli Kasim, Mesut Demir, Ulugbek I. Nizamov, Aldo Ferreira-Hermosillo, Dilek Yesilbursa, Atef Elbahry, Arshad Abdulrasheed, Omer A. Elamin, Vasileios Athyros, Joanna Lewek, Gergely Nagy, Ursula Kassner, Jian Jiao, Klaus G. Parhofer, Charlotte Nzeyimana, Marcin Pajkowski, Stanislav Zemek, Jose J.C. Macías, Cornelius Müller, G. Sfikas, Leopoldo Pérez de Isla, Yulia Ragino, Fahad Al-Zadjali, Abdul Rais Sanusi, Anna Rita Roscini, Jean Ferrières, Selim Jambart, Jean Pierre Rabes, Laura Schreier, Hofit Cohen, Olivier S. Descamps, N. Lalic, Christine Stumpp, Antonio J. Vallejo-Vaz, Jutta Christmann, Manuela Casula, Mariko Harada-Shiba, Olga Lunegova, Ewa Starostecka, Nicolas D. Oca, Alain Carrié, Achilleas Attilakos, Savas Ozer, Andreea Dumitrescu, Jürgen Merke, Urte Aliosaitiene, Evangelos Liberopoulos, Manuel O. De los Rios Ibarra, Maria J. Virtuoso, Alessandro Lupi, Panagiotis Anagnostis, Ruth Agar, Dorota Ferrieres, George Liamis, José Eduardo Krieger, Mariann Harangi, Fouzia Sadiq, Francois Schiele, Saif Kamal, Mária Audikovszky, Peter Baumgartner, Marta Gazzotti, Daniel Gaudet, Ashanty F. Ortega, Marcin Gruchała, Philippe Moulin, Ljiljana Popovic, Luca Bonanni, E. 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Shah, Lukas Burda, Ersel Onrat, Manuel de los Reyes Barrera Bustillo, Mirjana Radovic, Arman Postadzhiyan, Nien-Tzu Chang, Aylin Yildirir, Martin Mäser, Bruno Fink, Svetlana Mosteoru, Ulrike Schatz, Luis A.V. Talavera, Magdalena Dusejovska, Richard Ceska, Faisal A. Al-Allaf, T.F. Ashavaid, Gereon Böll, Sona Machacova, Gonzalo C. Vargas, Antonio Gallo, Elina Pantchechnikova, Lukas Tichy, Gersina Rega-Kaun, Moses Elisaf, Branislav Vohnout, Antonio Bossi, Suad Al-Mukhaini, Natasa Rajkovic, Ursa Sustar, Merih Kutlu, Mohamed Sobhy, Britta Otte, Ana M. Medeiros, Borut Jug, Patrick Couture, Rodrigo Alonso, Wolfgang Seeger, Guzal J. Abdullaeva, Ahmet Celik, Nasreen Al-Sayed, Béla Benczúr, Petra E. Khoury, Rafezah Razali, Ma L.R. Osorio, Ruiying Zhang, Monica M.N. Usme, Humberto Garcia Aguilar, Ceyhun Ceyhan, Antje Spens, Christoph J. Binder, Volker Schrader, Terrance C.S. Jin, Neftali E.A. Villa, Aleksandra Michalska-Grzonkowska, Francesco Purrello, Marshima M. 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Shafy, Yuntao Li, Martine Paquette, Zuhier Awan, Arturo Pujia, Xiantao Song, Renata Cifkova, Alexandre C. Pereira, Ioannis Skoumas, Roman Cibulka, Tadej Battelino, Mariusz Gąsior, Ghada Kazamel, Lahore S.U. Shah, Eran Leitersdorf, Niki Katsiki, Daniel Elías-López, Khalid Al-Rasadi, Grete Talviste, Sarka Mala, Rocio M. Alvarado, Pavel Kraml, Gerret Paulsen, Angelina Passaro, Zsolt Karányi, Carine Ayoub, Vera Adamkova, Ivo Petrov, Turky H. Almigbal, Rohana Abdul Ghani, Franck Boccara, Brian W. McCrindle, François Martin, Jamshed J. Dalal, Shitong Cheng, Khalid Al-Waili, Chaoyi Zhang, Ramon M. Prado, Lubica Cibickova, Lubomira Fabryova, Tobias Wiesner, Thuhairah Hasrah Abdul Rahman, Tan J. Le, Marcello Arca, Sabine Scholl-Bürgi, Juan R. Saucedo, Georgijs Nesterovics, Carla V.M. Valencia, Alexander Stadelmann, Vasileios Kotsis, Lina Badimon, Shizuya Yamashita, Jose C.M. Oyervides, Lay K. 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I., Tziomalos K., Rallidis L., Kotsis V., Doumas M., Athyros V., Skalidis E., Kolovou G., Garoufi A., Bilianou E., Koutagiar I., Agapakis D., Kiouri E., Antza C., Katsiki N., Zacharis E., Attilakos A., Sfikas G., Koumaras C., Anagnostis P., Anastasiou G., Liamis G., Koutsogianni A.-D., Karanyi Z., Harangi M., Bajnok L., Audikovszky M., Mark L., Benczur B., Reiber I., Nagy G., Nagy A., Reddy L.L., Shah S.A.V., Ponde C.K., Dalal J.J., Sawhney J.P.S., Verma I.C., Altaey M., Al-Jumaily K., Rasul D., Abdalsahib A.F., Jabbar A.A., Al-ageedi M., Agar R., Cohen H., Ellis A., Gavishv D., Harats D., Henkin Y., Knobler H., Leavit L., Leitersdorf E., Rubinstein A., Schurr D., Shpitzen S., Szalat A., Casula M., Zampoleri V., Gazzotti M., Olmastroni E., Sarzani R., Ferri C., Repetti E., Sabba C., Bossi A.C., Borghi C., Muntoni S., Cipollone F., Purrello F., Pujia A., Passaro A., Marcucci R., Pecchioli V., Pisciotta L., Mandraffino G., Pellegatta F., Mombelli G., Branchi A., Fiorenza A.M., Pederiva 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B., Stoll, M., Stroes, E., Su, T. -C., Subramaniam, T., Susekov, A. V., Tilney, M., Tomlinson, B., Truong, T. H., Tselepis, A. D., Tybjaerg-Hansen, A., Vazquez Cardenas, A., Viigimaa, M., Wang, L., Yamashita, S., Kastelein, J. J. P., Bruckert, E., Vohnout, B., Schreier, L., Pang, J., Ebenbichler, C., Dieplinger, H., Innerhofer, R., Winhofer-Stockl, Y., Greber-Platzer, S., Krychtiuk, K., Speidl, W., Toplak, H., Widhalm, K., Stulnig, T., Huber, K., Hollerl, F., Rega-Kaun, G., Kleemann, L., Maser, M., Scholl-Burgi, S., Saly, C., Mayer, F. J., Sablon, G., Tarantino, E., Nzeyimana, C., Pojskic, L., Sisic, I., Nalbantic, A. D., Jannes, C. E., Pereira, A. C., Krieger, J. E., Petrov, I., Goudev, A., Nikolov, F., Tisheva, S., Yotov, Y., Tzvetkov, I., Baass, A., Bergeron, J., Bernard, S., Brisson, D., Brunham, L. R., Cermakova, L., Couture, P., Francis, G. A., Gaudet, D., Hegele, R. A., Khoury, E., Mancini, G. B. J., Mccrindle, B. W., Paquette, M., Ruel, I., Cuevas, A., Asenjo, S., Wang, X., Meng, K., Song, X., Yong, Q., Jiang, T., Liu, Z., Duan, Y., Hong, J., Ye, P., Chen, Y., Qi, J., Li, Y., Zhang, C., Peng, J., Yang, Y., Yu, W., Wang, Q., Yuan, H., Cheng, S., Jiang, L., Chong, M., Jiao, J., Wu, Y., Wen, W., Xu, L., Zhang, R., Qu, Y., He, J., Fan, X., Wang, Z., Chow, E., Pecin, I., Perica, D., Symeonides, P., Vrablik, M., Ceska, R., Soska, V., Tichy, L., Adamkova, V., Franekova, J., Cifkova, R., Kraml, P., Vonaskova, K., Cepova, J., Dusejovska, M., Pavlickova, L., Blaha, V., Rosolova, H., Nussbaumerova, B., Cibulka, R., Vaverkova, H., Cibickova, L., Krejsova, Z., Rehouskova, K., Malina, P., Budikova, M., Palanova, V., Solcova, L., Lubasova, A., Podzimkova, H., Bujdak, J., Vesely, J., Jordanova, M., Salek, T., Urbanek, R., Zemek, S., Lacko, J., Halamkova, H., Machacova, S., Mala, S., Cubova, E., Valoskova, K., Burda, L., Bendary, A., Daoud, I., Emil, S., Elbahry, A., Rafla, S., Sanad, O., Kazamel, G., Ashraf, M., Sobhy, M., El-Hadidy, A., Shafy, M. A., Kamal, S., Bendary, M., Talviste, G., Angoulvant, D., Boccara, F., Cariou, B., Carreau, V., Carrie, A., Charrieres, S., Cottin, Y., Di-Fillipo, M., Ducluzeau, P. H., Dulong, S., Durlach, V., Farnier, M., Ferrari, E., Ferrieres, D., Ferrieres, J., Gallo, A., Hankard, R., Inamo, J., Lemale, J., Moulin, P., Paillard, F., Peretti, N., Perrin, A., Pradignac, A., Rabes, J. P., Rigalleau, V., Sultan, A., Schiele, F., Tounian, P., Valero, R., Verges, B., Yelnik, C., Ziegler, O., Haack, I. A., Schmidt, N., Dressel, A., Klein, I., Christmann, J., Sonntag, A., Stumpp, C., Boger, D., Biedermann, D., Usme, M. M. N., Beil, F. U., Klose, G., Konig, C., Gouni-Berthold, I., Otte, B., Boll, G., Kirschbaum, A., Merke, J., Scholl, J., Segiet, T., Gebauer, M., Predica, F., Mayer, M., Leistikow, F., Fullgraf-Horst, S., Muller, C., Schuler, M., Wiener, J., Hein, K., Baumgartner, P., Kopf, S., Busch, R., Schomig, M., Matthias, S., Allendorf-Ostwald, N., Fink, B., Bohm, D., Jakel, A., Koschker, A. -C., Schweizer, R., Vogt, A., Parhofer, K., Konig, W., Reinhard, W., Bassler, A., Stadelmann, A., Schrader, V., Katzmann, J., Tarr, A., Steinhagen-Thiessen, E., Kassner, U., Paulsen, G., Homberger, J., Zemmrich, C., Seeger, W., Biolik, K., Deiss, D., Richter, C., Pantchechnikova, E., Dorn, E., Schatz, U., Julius, U., Spens, A., Wiesner, T., Scholl, M., Rizos, C. V., Sakkas, N., Elisaf, M., Skoumas, I., Tziomalos, K., Rallidis, L., Kotsis, V., Doumas, M., Athyros, V., Skalidis, E., Kolovou, G., Garoufi, A., Bilianou, E., Koutagiar, I., Agapakis, D., Kiouri, E., Antza, C., Katsiki, N., Zacharis, E., Attilakos, A., Sfikas, G., Koumaras, C., Anagnostis, P., Anastasiou, G., Liamis, G., Koutsogianni, A. -D., Karanyi, Z., Harangi, M., Bajnok, L., Audikovszky, M., Mark, L., Benczur, B., Reiber, I., Nagy, G., Nagy, A., Reddy, L. L., Shah, S. A. V., Ponde, C. K., Dalal, J. J., Sawhney, J. P. S., Verma, I. C., Altaey, M., Al-Jumaily, K., Rasul, D., Abdalsahib, A. F., Jabbar, A. A., Al-ageedi, M., Agar, R., Cohen, H., Ellis, A., Gavishv, D., Harats, D., Henkin, Y., Knobler, H., Leavit, L., Leitersdorf, E., Rubinstein, A., Schurr, D., Shpitzen, S., Szalat, A., Casula, M., Zampoleri, V., Gazzotti, M., Olmastroni, E., Sarzani, R., Ferri, C., Repetti, E., Sabba, C., Bossi, A. C., Borghi, C., Muntoni, S., Cipollone, F., Purrello, F., Pujia, A., Passaro, A., Marcucci, R., Pecchioli, V., Pisciotta, L., Mandraffino, G., Pellegatta, F., Mombelli, G., Branchi, A., Fiorenza, A. M., Pederiva, C., Werba, J. P., Parati, G., Carubbi, F., Iughetti, L., Iannuzzi, A., Iannuzzo, G., Calabro, P., Averna, M., Biasucci, G., Zambon, S., Roscini, A. R., Trenti, C., Arca, M., Federici, M., Del Ben, M., Bartuli, A., Giaccari, A., Pipolo, A., Citroni, N., Guardamagna, O., Bonomo, K., Benso, A., Biolo, G., Maroni, L., Lupi, A., Bonanni, L., Zenti, M. G., Matsuki, K., Hori, M., Ogura, M., Masuda, D., Kobayashi, T., Nagahama, K., Al-Jarallah, M., Radovic, M., Lunegova, O., Bektasheva, E., Khodzhiboboev, E., Erglis, A., Gilis, D., Nesterovics, G., Saripo, V., Meiere, R., Upena-RozeMicena, A., Terauda, E., Jambart, S., Khoury, P. E., Elbitar, S., Ayoub, C., Ghaleb, Y., Aliosaitiene, U., Kutkiene, S., Kasim, N. A. M., Nor, N. S. M., Ramli, A. S., Razak, S. A., Al-Khateeb, A., Kadir, S. H. S. A., Muid, S. A., Rahman, T. A., Kasim, S. S., Radzi, A. B. M., Ibrahim, K. S., Razali, S., Ismail, Z., Ghani, R. A., Hafidz, M. I. A., Chua, A. L., Rosli, M. M., Annamalai, M., Teh, L. K., Razali, R., Chua, Y. A., Rosman, A., Sanusi, A. R., Murad, N. A. A., Jamal, A. R. A., Nazli, S. A., Razman, A. Z., Rosman, N., Rahmat, R., Hamzan, N. S., Azzopardi, C., Mehta, R., Martagon, A. J., Ramirez, G. A. G., Villa, N. E. A., Vazquez, A. V., Elias-Lopez, D., Retana, G. G., Rodriguez, B., Macias, J. J. C., Zazueta, A. R., Alvarado, R. M., Portano, J. D. M., Lopez, H. A., Sauque-Reyna, L., Herrera, L. G. G., Mendia, L. E. S., Aguilar, H. G., Cooremans, E. R., Aparicio, B. P., Zubieta, V. M., Gonzalez, P. A. C., Ferreira-Hermosillo, A., Portilla, N. C., Dominguez, G. J., Garcia, A. Y. R., Cazares, H. E. A., Gonzalez, J. R., Valencia, C. V. M., Padilla, F. G., Prado, R. M., De los Rios Ibarra, M. O., Villicana, R. D. A., Rivera, K. J. A., Carrera, R. A., Alvarez, J. A., Martinez, J. C. A., de los Reyes Barrera Bustillo, M., Vargas, G. C., Chacon, R. C., Andrade, M. H. F., Ortega, A. F., Alcala, H. G., de Leon, L. E. G., Guzman, B. G., Garcia, J. J. G., Cuellar, J. C. G., Cruz, J. R. G., Garcia, A. H., Almada, J. R. H., Herrera, U. J., Sobrevilla, F. L., Rodriguez, E. M., Sibaja, C. M., Rodriguez, A. B. M., Oyervides, J. C. M., Vazquez, D. I. P., Rodriguez, E. A. R., Osorio, M. L. R., Saucedo, J. R., Tamayo, M. T., Talavera, L. A. V., Arroyo, L. E. V., Carrillo, E. A. Z., Isara, A., Obaseki, D. E., Al-Waili, K., Al-Zadjali, F., Al-Zakwani, I., Al-Kindi, M., Al-Mukhaini, S., Al-Barwani, H., Rana, A., Shah, L. S. U., Starostecka, E., Konopka, A., Lewek, J., Bartlomiejczyk, M., Gasior, M., Dyrbus, K., Jozwiak, J., Gruchala, M., Pajkowski, M., Romanowska-Kocejko, M., Zarczynska-Buchowiecka, M., Chmara, M., Wasag, B., Parczewska, A., Gilis-Malinowska, N., Borowiec-Wolna, J., Strozyk, A., Wos, M., Michalska-Grzonkowska, A., Medeiros, A. M., Alves, A. C., Silva, F., Lobarinhas, G., Palma, I., de Moura, J. P., Rico, M. T., Rato, Q., Pais, P., Correia, S., Moldovan, O., Virtuoso, M. J., Salgado, J. M., Colaco, I., Dumitrescu, A., Lengher, C., Mosteoru, S., Meshkov, A., Ershova, A., Rozkova, T., Korneva, V., Yu, K. T., Zafiraki, V., Voevoda, M., Gurevich, V., Duplyakov, D., Ragino, Y., Safarova, M., Shaposhnik, I., Alkaf, F., Khudari, A., Rwaili, N., Al-Allaf, F., Alghamdi, M., Batais, M. A., Almigbal, T. H., Kinsara, A., Alqudaimi, A. H. A., Awan, Z., Elamin, O. A., Altaradi, H., Rajkovic, N., Popovic, L., Singh, S., Stosic, L., Rasulic, I., Lalic, N. M., Lam, C., Le, T. J., Siang, E. L. T., Dissanayake, S., I-Shing, J. T., Shyong, T. E., Jin, T. C. S., Balinth, K., Buganova, I., Fabryova, L., Kadurova, M., Klabnik, A., Kozarova, M., Sirotiakova, J., Battelino, T., Kovac, J., Mlinaric, M., Sustar, U., Podkrajsek, K. T., Fras, Z., Jug, B., Cevc, M., Pilcher, G. J., Blom, D. J., Wolmarans, K. H., Brice, B. C., Muniz-Grijalvo, O., Diaz-Diaz, J. L., de Isla, L. P., Fuentes, F., Badimon, L., Martin, F., Lux, A., Chang, N. -T., Ganokroj, P., Akbulut, M., Alici, G., Bayram, F., Can, L. H., Celik, A., Ceyhan, C., Coskun, F. Y., Demir, M., Demircan, S., Dogan, V., Durakoglugil, E., Dural, I. E., Gedikli, O., Hacioglu, A., Ildizli, M., Kilic, S., Kirilmaz, B., Kutlu, M., Oguz, A., Ozdogan, O., Onrat, E., Ozer, S., Sabuncu, T., Sahin, T., Sivri, F., Sonmez, A., Temizhan, A., Topcu, S., Tuncez, A., Vural, M., Yenercag, M., Yesilbursa, D., Yigit, Z., Yildirim, A. B., Yildirir, A., Yilmaz, M. B., Atallah, B., Traina, M., Sabbour, H., Hay, D. A., Luqman, N., Elfatih, A., Abdulrasheed, A., Kwok, S., Oca, N. D., Reyes, X., Alieva, R. B., Kurbanov, R. D., Hoshimov, S. U., Nizamov, U. I., Ziyaeva, A. V., Abdullaeva, G. J., Do, D. L., Nguyen, M. N. T., Kim, N. T., Le, T. T., Le, H. A., Tokgozoglu, L., Catapano, A. L., Ray, K. K., and EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC), Borghi C
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Male ,Settore MED/09 - Medicina Interna ,Arterial disease ,Cross-sectional study ,Adult population ,Coronary Disease ,Disease ,Global Health ,Medical and Health Sciences ,Doenças Cardio e Cérebro-vasculares ,Anticholesteremic Agent ,Monoclonal ,Prevalence ,Registries ,Familial Hypercholesterolemia ,Humanized ,Stroke ,11 Medical and Health Sciences ,LS2_9 ,Studies Collaboration ,Anticholesteremic Agents ,General Medicine ,Heart Disease Risk Factor ,Middle Aged ,FHSC global registry data ,Europe ,Treatment Outcome ,Lower prevalence ,Guidance ,lipids (amino acids, peptides, and proteins) ,Female ,Proprotein Convertase 9 ,Familial hypercholesterolaemia ,Life Sciences & Biomedicine ,Human ,Adult ,medicine.medical_specialty ,Combination therapy ,FHSC global registry, heterozygous familial hypercholesterolaemia ,Cardiovascular risk factors ,Antibodies, Monoclonal, Humanized ,Insights ,Antibodies ,NO ,Hyperlipoproteinemia Type II ,Clinician ,Medicine, General & Internal ,Internal medicine ,General & Internal Medicine ,Health Sciences ,medicine ,Humans ,EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC) ,Cross-Sectional Studie ,Science & Technology ,Global Perspective ,business.industry ,Cholesterol, LDL ,medicine.disease ,Cross-Sectional Studies ,Heart Disease Risk Factors ,Hydroxymethylglutaryl-CoA Reductase Inhibitor ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business - Abstract
Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. Findings Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53.6%] women) from 56 countries were included in the study. Of these, 31 798 (75.4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84.2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46.2 years (IQR 34.3-58.0); median age at diagnosis of familial hypercholesterolaemia was 44.4 years (32.5-56.5), with 40.2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17.4% (2.1% for stroke and 5.2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81.1%) were receiving statins and 3691 (21.2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5.43 mmol/L (IQR 4.32-6.72) among patients not taking lipid-lowering medications and 4.23 mmol/L (3.20-5.66) among those taking them. Among patients taking lipid-lowering medications, 2.7% had LDL cholesterol lower than 1.8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin-kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1.8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p, Pfizer Independent Grant for Learning Change [16157823]; Amgen; Merck Sharp Dohme; Sanofi-Aventis; Daiichi Sankyo; Regeneron; National Institute for Health Research (NIHR) Imperial Biomedical Research Centre, UK; NIHR; Czech Ministry of Health [NU20-02-00261]; Canadian Institutes of Health Research; Austrian Heart Foundation; Tyrolean Regional Government; Gulf Heart Association, The EAS FHSC is an academic initiative that has received funding from a Pfizer Independent Grant for Learning & Change 2014 (16157823) and from investigator-initiated research grants to the European Atherosclerosis Society-Imperial College London from Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron. KKR acknowledges support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre, UK. KID acknowledges support from a PhD Studentship from NIHR under the Applied Health Research programme for Northwest London, UK (the views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health). TF was supported by a grant from the Czech Ministry of Health (NU20-02-00261). JG receives support from the Canadian Institutes of Health Research. The Austrian Familial Hypercholesterolaemia registry has been supported by funds from the Austrian Heart Foundation and the Tyrolean Regional Government. The Gulf Familial Hypercholesterolaemia registry was done under the auspices of the Gulf Heart Association.
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- 2021
16. Comparison of Contemporary Risk Scores in All Groups of Pulmonary Hypertension: A Pulmonary Vascular Research Institute GoDeep Meta-Registry Analysis.
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Yogeswaran A, Gall H, Fünderich M, Wilkins MR, Howard L, Kiely DG, Lawrie A, Hassoun PM, Sirenklo Y, Torbas O, Sweatt AJ, Zamanian RT, Williams PG, Frauendorf M, Arvanitaki A, Giannakoulas G, Saleh K, Sabbour H, Cajigas HR, Frantz R, Al Ghouleh I, Chan SY, Brittain E, Annis JS, Pepe A, Ghio S, Orfanos S, Anthi A, Majeed RW, Wilhelm J, Ghofrani HA, Richter MJ, Grimminger F, Sahay S, Tello K, and Seeger W
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- Humans, Prognosis, Risk Assessment methods, Hypertension, Pulmonary epidemiology, Hypertension, Pulmonary physiopathology, Registries statistics & numerical data
- Abstract
Background: Pulmonary hypertension (PH) is a heterogeneous disease with a poor prognosis. Accurate risk stratification is essential for guiding treatment decisions in pulmonary arterial hypertension (PAH). Although various risk models have been developed for PAH, their comparative prognostic potential requires further exploration. Additionally, the applicability of risk scores in PH groups beyond group 1 remains to be investigated., Research Question: Are risk scores originally developed for PAH predictive in PH groups 1 through 4?, Study Design and Methods: We conducted a comprehensive analysis of outcomes among patients with incident PH enrolled in the multicenter worldwide Pulmonary Vascular Research Institute GoDeep meta-registry. Analyses were performed across PH groups 1 through 4 and further subgroups to evaluate the predictive value of PAH risk scores, including the Registry to Evaluate Early and Long-Term PAH Disease Mangement (REVEAL) Lite 2, REVEAL 2.0, European Society of Cardiology/European Respiratory Society 2022, Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) 3-strata, and COMPERA 4-strata., Results: Eight thousand five hundred sixty-five patients were included in the study, of whom 3,537 patients were assigned to group 1 PH, whereas 1,807 patients, 1,635 patients, and 1,586 patients were assigned to group 2 PH, group 3 PH, and group 4 PH, respectively. Pulmonary hemodynamics were impaired with median mean pulmonary arterial pressure of 42 mm Hg (interquartile range, 33-52 mm Hg) and pulmonary vascular resistance of 7 Wood units (WU) (interquartile range, 4-11 WU). All risk scores were prognostic in the entire PH population and in each of the PH groups 1 through 4. The REVEAL scores, when used as continuous prediction models, demonstrated the highest statistical prognostic power and granularity; the COMPERA 4-strata risk score provided subdifferentiation of the intermediate-risk group. Similar results were obtained when separately analyzing various subgroups (PH subgroups 1.1, 1.4.1, and 1.4.4; PH subgroups 3.1 and 3.2; group 2 with isolated postcapillary PH vs combined precapillary and postcapillary PH; patients of all groups with concomitant cardiac comorbidities; and severe [> 5 WU] vs nonsevere PH)., Interpretation: This comprehensive study with real-world data from 15 PH centers showed that PAH-designed risk scores possess predictive power in a large PH cohort, whether considered as common to the group or calculated separately for each PH group (1-4) and various subgroups., Trial Registry: ClinicalTrials.gov; No.: NCT05329714; URL: www., Clinicaltrials: gov., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: A. Y. has received personal fees from MSD. H. G. has received personal fees from Actelion, AstraZeneca, Bayer, BMS, GossamerBio, GSK, Janssen-Cilag, Lilly, MSD, Novartis, OMT, Pfizer, and United Therapeutics. M. R. W. reports personal fees from MorphogenIX, Janssen, Chiesi, and Aerami; grants from British Heart Foundation and NIHR; and personal fees from MSD, Benevolent AI, and Tiakis Biotech, outside the submitted work. L. H. reports personal fees and nonfinancial support from Janssen and personal fees from MSD, Gossamer, and Altavant. D. G. K. reports support for the present manuscript from the Sheffield Biomedical Research Centre and consulting fees and other payments from Jansen Pharmaceuticals, Ferrer, Altavant, MSD, and United therapeutics. P. M. H. reports personal fees from Merck Co. S. Y. C. reports personal fees from Janssen, Bayer, Pfizer, United Therapeutics, and Acceleron Pharma and is a director, officer, and shareholder of Synhale Therapeutics. S. O. reports personal fees from MSD, Janssen, and Gallenica-Ferrer. H. A. G. has received fees from Actelion, AstraZeneca, Bayer, GSK, Janssen-Cilag, Lilly, Novartis, OMT, Pfizer, and United Therapeutics. M. J. R. has received support from Janssen Pharmaceutica and Bayer Pharma AG and speaker fees from Janssen Pharmaceutica and OMT. S. S. reports personal fees from Gossamer Bio, Merck, Keros, Janssen, United Therapeutics, and Liquidia. K. T. has received personal fees from Bayer, AstraZeneca, and Gossamer. W. S. has received consultancy fees from United Therapeutics, Tiakis Biotech AG, Liquidia, Pieris Pharmaceuticals, Abivax, Pfitzer, and Medspray BV. None declared (M. Fünderich, A.L., Y. S., O. T., A. J. S., R. T. Z., P. G. W., M. Frauendorf, A. Arvanitaki, G. G., K. S., H. R. C., R. F., I. A. G., E. B., J. S. A., A. P., S. G., A. Anthi, R. W. M., J. W., F. G.), (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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17. Trends and findings of lipoprotein(a) testing and associated cardiovascular disease profiles: a large single-center study from the Middle East-Gulf region.
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Manla Y, AbdelWareth L, Shantouf R, Aljabery Y, St John TL, Sabbour H, Piechowski-Jozwiak B, and Almahmeed W
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Background: Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (CVD). Limited data are available on Lp(a) testing from the Middle-East region. Therefore, we aim to evaluate the utilization and yield of Lp(a) testing over time and characterize CVD profiles of patients with abnormal Lp(a) tasting at a single-quaternary-care center in the United Arab Emirates., Methods: Unique Lp(a) tests conducted between 07/2017 and 10-2023 were included. Overtime trends in Lp(a) test utilization and abnormal Lp(a) [defined as Lp(a) > 125 nmol/L] test findings were described. CVD rates in patients with abnormal Lp(a) were compared to those with Lp(a) ≤ 125 nmol/L using appropriate methods., Results: In our center, 0.95% of the patients ( n = 5,677) had their Lp(a) measured, with a median level of 32 [11-82] nmol/L. Lp(a) was abnormal in 15.9% of the tests. Over the years 2018-2022, there was a 109% increase in Lp(a) testing, with concomitant up-trends in findings of abnormal Lp(a) (11.8% to 16.4%, P = 0.02). Compared to patients with Lp(a) ≤ 125 nmol/I, those with abnormal Lp(a) had higher rates of any prevalent CVD (34% vs. 25.1%, P < 0.001), CAD (25.6% vs. 17.7%, P < 0.001), HF (6.5% vs. 3.8%, P < 0.001), and stroke (7.1% vs. 4.4%, P < 0.001)., Conclusion: Almost one in six patients tested for Lp(a) had abnormally elevated Lp(a), and CVD was prevalent in one-third of the patients who tested abnormal for Lp(a). The study highlights the growing awareness of the relevance of Lp(a) for CVD risk stratification and prevention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Manla, AbdelWareth, Shantouf, Aljabery, St John, Sabbour, Piechowski-Jozwiak and Almahmeed.)
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- 2024
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18. Cardiovascular disease risk scores in patients with optimal vs suboptimal weight loss after bariatric surgery: Translating improvements into clinical practice.
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Salih RM, Barajas-Gamboa JS, Del Gobbo GD, Abdallah M, Sun H, Lee-St John T, Kanwar O, Abril C, Pantoja JP, Raza J, Sabbour H, Rodriguez J, Kroh M, and Corcelles R
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- Humans, Retrospective Studies, Female, Male, Middle Aged, Adult, Risk Assessment, Obesity, Morbid surgery, Obesity, Morbid complications, Heart Disease Risk Factors, Weight Loss, Bariatric Surgery, Cardiovascular Diseases prevention & control, Cardiovascular Diseases etiology
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Introduction: The aim of this study was to evaluate cardiovascular disease (CVD) risk modification in patients with optimal weight loss (OWL) versus suboptimal weight loss SWL following MBS., Methods: This was a retrospective analysis. The 10-year risk CVD was estimated before and after one year of surgery using the "Framingham Score"., Results: 191 patients were included in our study. Mean baseline Framingham score was 7.2 ± 6.9%. According to the score, 54% of patients were classified as low risk (n = 104), 23% as moderate (n = 43), 20% moderately high (n = 39) and 3% as high risk (n = 5). One year after surgery, 91% of the patients showed reduction of their Framingham score. Mean CVD risk score decreased significantly to 4.1 ± 3.7% when compared to baseline (p-value is < 0.001); 80% of patients classified as low risk (n = 153), 13% as moderate (n = 25), 7% moderately high (n = 13) and 0% as high risk (n = 0)., Conclusion: Weight loss after bariatric surgery reduces CVD risk scores and the magnitude of effect correlates with the degree of weight loss., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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19. Correction to: Effectiveness and safety of the combination of sodium-glucose transport protein 2 inhibitors and glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies.
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Ahmad A and Sabbour H
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- 2024
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20. Corrigendum: A wolf in sheep's clothing-aortic stenosis and cardiac amyloidosis: "RAISE"ing awareness in clinical practice.
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Sabbour H, Al-Humood K, Al Taha Z, Romany I, Haddadin H, and Mohty D
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[This corrects the article DOI: 10.3389/fcvm.2024.1323023.]., (© 2024 Sabbour, Al-Humood, Al Taha, Romany, Haddadin and Mohty.)
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- 2024
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21. Effectiveness and safety of the combination of sodium-glucose transport protein 2 inhibitors and glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies.
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Ahmad A and Sabbour H
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- Humans, Hypoglycemic Agents adverse effects, Glucagon-Like Peptide-1 Receptor Agonists, Glycated Hemoglobin, Blood Glucose metabolism, Cholesterol, Glucagon-Like Peptide-1 Receptor agonists, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy
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Background: Randomized controlled trials and real-world studies suggest that combination therapy with sodium-glucose transport protein 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) is associated with improvement in fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), body mass index (BMI), and total cholesterol levels. However, a systematic review of available real-world evidence may facilitate clinical decision-making in the real-world scenario. This meta-analysis assessed the safety and effectiveness of combinations of SGLT2is + GLP-1RAs with a focus on their cardioprotective effects along with glucose-lowering ability in patients with type 2 diabetes mellitus (T2DM) in a real-world setting., Methods: Electronic searches were performed in the PubMed/MEDLINE, PROQuest, Scopus, CINAHL, and Google Scholar databases. Qualitative analyses and meta-analyses were performed using the Joanna Briggs Institute SUMARI software package and Review Manager v5.4, respectively., Results: The initial database search yielded 1445 articles; of these, 13 were included in this study. The analyses indicated that SGLT2is + GLP-1RAs combinations were associated with significantly lower all-cause mortality when compared with individual therapies (odds ratio [95% confidence interval [CI] 0.49 [0.41, 0.60]; p < 0.00001). Significant reductions in BMI (- 1.71 [- 2.74, - 0.67]; p = 0.001), SBP (- 6.35 [- 10.17, - 2.53]; p = 0.001), HbA1c levels (- 1.48 [- 1.75, - 1.21]; p < 0.00001), and FPG (- 2.27 [- 2.78, - 1.76]; p < 0.00001) were associated with the simultaneous administration of the combination. Changes in total cholesterol levels and differences between simultaneous and sequential combination therapies for this outcome were not significant., Conclusion: This systematic review and meta-analysis based on real-world data suggests that the combination of SGLT2is + GLP-1RAs is associated with lower all-cause mortality and favorable improvements in cardiovascular, renal, and glycemic measurements. The findings drive a call-to-action to incorporate this combination early and simultaneously in managing T2DM patients and achieve potential cardiovascular benefits and renal protection., (© 2024. The Author(s).)
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- 2024
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22. A Practical Approach to the Management of Residual Cardiovascular Risk: United Arab Emirates Expert Consensus Panel on the Evidence for Icosapent Ethyl and Omega-3 Fatty Acids.
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Sabbour H, Bhatt DL, Elhenawi Y, Aljaberi A, Bennani L, Fiad T, Hasan K, Hashmani S, Hijazi RA, Khan Z, and Shantouf R
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Purpose: Patients with hyperlipidemia treated with statins remain at a residual cardiovascular (CV) risk. Omega-3 polyunsaturated fatty acids hold the potential to mitigate the residual CV risk in statin-treated patients, with persistently elevated triglyceride (TG) levels., Method: We reviewed the current evidence on the use of icosapent ethyl (IPE), an omega-3 fatty acid yielding a pure form of eicosapentaenoic acid., Results: REDUCE-IT reported a significant 25% reduction in CV events, including the need for coronary revascularization, the risk of fatal/nonfatal myocardial infarction, stroke, hospitalization for unstable angina, and CV death in patients on IPE, unseen with other omega-3 fatty acids treatments. IPE was effective in all patients regardless of baseline CV risk enhancers (TG levels, type-2 diabetes status, weight status, prior revascularization, or renal function). Adverse events (atrial fibrillation/flutter) related to IPE have occurred mostly in patients with prior atrial fibrillation. Yet, the net clinical benefit largely exceeded potential risks. The combination with other omega-3 polyunsaturated fatty acids, in particular DHA, eliminated the effect of EPA alone, as reported in the STRENGTH and OMEMI trials. Adding IPE to statin treatment seems to be cost-effective, especially in the context of secondary prevention of CVD, decreasing CV event frequency and subsequently the use of healthcare resources., Conclusion: Importantly, IPE has been endorsed by 20 international medical societies as a statin add-on treatment in patients with dyslipidemia and high CV risk. Robust medical evidence supports IPE as a pillar in the management of dyslipidemia., (© 2024. The Author(s).)
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- 2024
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23. Flash'O real-world evidence programme - Attitude and practices toward the use of omega-3 FA by physicians from Middle East Countries.
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Kinsara AJ and Sabbour H
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- Humans, Male, United States, Female, Middle East, Diabetes Mellitus, Type 2, Fatty Acids, Omega-3 therapeutic use, Physicians, Dyslipidemias drug therapy, Dyslipidemias epidemiology
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The Flash'O project was designed to provide insights into the current use of prescription omega-3 and their perceived benefits by physicians in real-world clinical practice, in Russia, Saudi Arabia, Thailand, and Gulf countries, and to determine the adherence of physicians to dyslipidemia management guidelines. The present study focuses on Flash'O's process and results in Middle East countries. A total of 338 physicians and specialists completed the online questionnaire. Most responding physicians were male (91.7%), general practitioners (42.6%) with more than 5 years of seniority (80.4%) and saw more than 50 patients a week (71.5%). Most surveyed physicians (64.2%) reported using guidelines in their daily practice for the management of their patients with dyslipidemia. They mostly followed national guidelines (68.6%). American or European ones were less commonly used. Responding physicians thought that omega-3 supplementation could be more beneficial in all types of dyslipidemia, except high non- hight density lipoproteins, and for patients suffering from obesity, type 2 diabetes mellitus, acute coronary syndrome with ST-segment elevation myocardial infarction and high cardiovascular diseases risk (score ≥ 5% and < 10%), but less beneficial in chronic kidney disease. Respondents recommended omega-3 to their patients mainly after statin treatment in patients with dyslipidemia and for the treatment of dyslipidemia. This survey confirmed that omega-3 fatty acids are at the heart of the cardiovascular medical strategy., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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24. Regional expert opinion: Management of heart failure with preserved ejection fraction in the Middle East, North Africa and Turkey.
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Abdelhamid M, Al Ghalayini K, Al-Humood K, Altun B, Arafah M, Bader F, Ibrahim M, Sabbour H, Shawky Elserafy A, Skouri H, and Yilmaz MB
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- Humans, Middle East epidemiology, Africa, Northern epidemiology, Turkey epidemiology, Disease Management, Prevalence, Risk Factors, Expert Testimony, Heart Failure epidemiology, Heart Failure physiopathology, Heart Failure therapy, Stroke Volume physiology
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Although epidemiological data on heart failure (HF) with preserved ejection fraction (HFpEF) are scarce in the Middle East, North Africa and Turkey (MENAT) region, Lancet Global Burden of Disease estimated the prevalence of HF in the MENAT region in 2019 to be 0.78%, versus 0.71% globally. There is also a high incidence of HFpEF risk factors and co-morbidities in the region, including coronary artery disease, diabetes, obesity, hypertension, anaemia and chronic kidney disease. For instance, 14.5-16.2% of adults in the region reportedly have diabetes, versus 7.0% in Europe. Together with increasing life expectancy, this may contribute towards a higher burden of HFpEF in the region than currently reported. This paper aims to describe the epidemiology and burden of HFpEF in the MENAT region, including unique risk factors and co-morbidities. It highlights challenges with diagnosing HFpEF, such as the prioritization of HF with reduced ejection fraction (HFrEF), the specific profile of HFpEF patients in the region and barriers to effective management associated with the healthcare system. Guidance is given on the diagnosis, prevention and management of HFpEF, including the emerging role of sodium-glucose co-transporter-2 inhibitors. Given the high burden of HFpEF coupled with the fact that its prevalence is likely to be underestimated, healthcare professionals need to be alert to its signs and symptoms and to manage patients accordingly. Historically, HFpEF treatments have focused on managing co-morbidities and symptoms, but new agents are now available with proven effects on outcomes in patients with HFpEF., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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- 2023
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25. Attacking the Achilles heel of cardiac amyloid nuclear scintigraphy: How to reduce equivocal and false positive studies.
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Al Taha Z, Alibazoglu D, Sabbour H, Romany I, Alibazoglu H, and Bokhari S
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- Humans, Retrospective Studies, Single Photon Emission Computed Tomography Computed Tomography, Tomography, Emission-Computed, Single-Photon methods, Amyloidosis
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Background: Planar and single-photon emission computed tomography (SPECT) nuclear imaging techniques with bone seeking radiotracers have been increasingly adopted for diagnosis of ATTR cardiac amyloidosis. However, inherent limitations of these techniques due to lack of anatomical landmarks have been recognized, with consequent high numbers of equivocal or false positive cases. SPECT/computed tomography (CT) fusion imaging offers a significant advantage to overcome these limitations by substantially reducing inaccurate interpretations. The authors present the results of a 3-year imaging quality improvement project that focused on reducing the high number of equivocal studies that were noted in the first two years of the amyloidosis program, comparing SPECT only to SPECT/CT fusion technique., Methods: A retrospective, systematic analysis of 176 patient records was performed to test the premise that SPECT/CT fusion imaging has the potential to reduce equivocal and false positive results., Results: Of a total of 176 patients, 35 equivocal (19.8%), 32 (18.18%) strongly suggestive, and 109 (61.93%) not suggestive cases were identified. Recognizing that this was not consistent with the international data, the authors set out on a comprehensive quality assessment project to reduce the number of equivocal and false positive cases. In patients who initially underwent SPECT only (Group A; n = 78), the addition of SPECT/CT fusion resulted in the net reclassification of 73% of cases: 100% of equivocal cases (n = 35) were reclassified to not suggestive (n = 34) or strongly suggestive (n = 1). 73% of strongly suggestive cases (n = 30) were reclassified to not suggestive (n = 22) while 8 strongly suggestive cases were confirmed as true positives. 13 not suggestive cases remained negative after SPECT/CT fusion. In cases where SPECT/CT fusion was utilized from the beginning (Group B; n = 98), there were no reclassification of any of the cases when these cases were reprocessed as a control group., Conclusion: Addition of SPECT/CT imaging reduces the false positive or equivocal studies and increases the diagnostic accuracy of the test. All false positive and equivocal studies were eliminated using the fusion technique. Utilizing the fusion imaging technique increases the spatial resolution, with the ability to localize myocardial uptake and accurately differentiate from blood pool, which is a major source of error., (© 2023. The Author(s).)
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- 2023
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26. Comprehensive description of the prevalence, serological and clinical characteristics, and visceral involvement of systemic sclerosis (scleroderma) in a large cohort from the United Arab Emirates Systemic Sclerosis Registry.
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Namas R, Elarabi M, Khan S, Mubashir A, Memisoglu E, El-Kaissi M, Joshi A, Chapman J, Jassim I, Khogali H, Hassan N, Sabbour H, Saleh K, Alnaqbi KA, Zayat AS, Diab S, Awir Z, Abu Taha N, Ginawi A, Al Ansari A, Rifaai H, Alrawi Z, Al Dhaheri A, Ibrahim G, Abogamal A, Al Shehhi W, Teir J, Khan T, Musgrave M, Hameed B, Khan B, Mosallam N, Hussien N, Hussein I, Abdulelhamid A, Ali A, Hannawi S, Al Izzi M, Badsha H, and Al Saleh J
- Abstract
Systemic sclerosis is an autoimmune condition characterized by a wide range of clinical presentations. Registries may serve to expand understanding about systemic sclerosis and aid in patient care and follow-up. The objective of this study was to analyze the prevalence of systemic sclerosis in a large cohort from the United Arab Emirates Systemic Sclerosis Registry and find the significant similarities and differences between the different subsets. All scleroderma patients in the United Arab Emirates were included in this multicenter national retrospective analysis. Data on demographics, comorbidities, serological characteristics, clinical aspects, and treatment were collected and analyzed, highlighting the most common traits identified. A total of 167 systemic scleroderma patients from diverse ethnic backgrounds were enrolled. Overall, 54.5% (91/167) of the patients were diagnosed with diffuse cutaneous systemic sclerosis, and 45.5% (76/167) with limited cutaneous systemic sclerosis. The prevalence of systemic sclerosis was 1.66 per 100,000 for the total registry and 7.78 per 100,000 for United Arab Emirates patients. Almost all patients in the diffuse cutaneous systemic sclerosis and limited cutaneous systemic sclerosis groups tested positive for the immunofluorescence antinuclear antibody. Antibodies against Scl-70 were significantly more associated with diffuse cutaneous systemic sclerosis, whereas anticentromere antibodies were significantly more associated with the limited cutaneous systemic sclerosis group ( p < 0.001). Sclerodactyly, shortness of breath, and digital ulcers were more common in diffuse cutaneous systemic sclerosis patients compared with the limited cutaneous systemic sclerosis subtype in terms of clinical symptoms and organ involvement. Telangiectasia was much more common in the limited cutaneous systemic sclerosis group. Furthermore, diffuse cutaneous systemic sclerosis patients had more lung fibrosis (interstitial lung disease) than limited cutaneous systemic sclerosis patients (70.5% vs 45.7%), and pulmonary arterial hypertension was twice as common in limited cutaneous systemic sclerosis patients as it was in diffuse cutaneous systemic sclerosis patients. Local registries are paramount to understanding the clinical/serological characteristics of scleroderma. This study emphasizes the importance of raising disease awareness and distinguishing between the various systemic sclerosis subsets to implement patient-tailored strategies for early detection, better management, and higher quality of care., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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27. A cross-sectional study of the prevalence and clinical management of atherosclerotic cardiovascular diseases in patients with type 2 diabetes across the Middle East and Africa (PACT-MEA): Study design and rationale.
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Verma S, Sabbour H, Alamuddin N, Alawadi F, Alkandari H, Almahmeed W, Assaad-Khalil SH, Haddad J, Lombard L, Malik RA, Mashaki Ceyhan E, Prasad P, Tombak G, and Salek S
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- Humans, Cross-Sectional Studies, Prevalence, Middle East epidemiology, Africa, Risk Factors, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Atherosclerosis epidemiology, Atherosclerosis therapy
- Abstract
Aim: To investigate the epidemiology and clinical management of patients with type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease (eASCVD) or high/very high ASCVD risk, defined by the 2021 European Society of Cardiology Guidelines, in seven countries in the Middle East and Africa (PACT-MEA; NCT05317845), and to assess physicians' attitudes and the basis for their decision-making in the management of these patients., Materials and Methods: PACT-MEA is a cross-sectional, observational study undertaken in Bahrain, Egypt, Jordan, Kuwait, Qatar, South Africa and the United Arab Emirates based on a medical chart review of approximately 3700 patients with T2D in primary and secondary care settings, and a survey of approximately 400 physicians treating patients with T2D., Results: The primary and secondary objectives are to determine the prevalence of eASCVD and high/very high ASCVD risk in patients with T2D. Current treatment with cardioprotective antidiabetic medication, the proportion of patients meeting the treatment criteria for reimbursement in the study countries where there is an applicable reimbursement guideline, and physician-reported factors in clinical decision-making in T2D management, will also be assessed., Conclusions: This large cross-sectional study will establish the estimated prevalence and management of eASCVD and high/very high ASCVD risk in patients with type 2 diabetes across the Middle East and Africa., (© 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
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- 2023
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28. Prevalence of Diabetes and Cardiovascular Risk in the Middle East and Africa: Primary Results of the PACT-MEA Study.
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Verma S, Alamuddin N, Alawadi F, Alkandari H, Almahmeed W, Assaad-Khalil SH, Haddad J, Husemoen LLN, Lombard L, Malik RA, Mashaki Ceyhan E, Sabbour H, Tombak G, Yadav G, and Salek S
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- Humans, Risk Factors, Prevalence, Africa epidemiology, Middle East epidemiology, Heart Disease Risk Factors, Cardiovascular Diseases epidemiology, Diabetes Mellitus, Type 2 epidemiology
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- 2023
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29. The First Pulmonary Hypertension Registry in the United Arab Emirates (UAEPH): Clinical Characteristics, Hemodynamic Parameters with Focus on Treatment and Outcomes for Patients with Group 1-PH.
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Saleh K, Khan N, Dougherty K, Bodi G, Michalickova M, Mohammed S, Kerenidi T, Sadik Z, Mallat J, Farha S, and Sabbour H
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Background: The aim of this study is to present the first United Arab Emirates pulmonary hypertension registry of patients' clinical characteristics, hemodynamic parameters and treatment outcomes., Method: This is a retrospective study describing all the adult patients who underwent a right heart catheterization for evaluation of pulmonary hypertension (PH) between January 2015 and December 2021 in a tertiary referral center in Abu Dhabi, United Arab Emirates., Results: A total of 164 consecutive patients were diagnosed with PH during the five years of the study. Eighty-three patients (50.6%) were World Symposium PH Group 1-PH; nineteen patients (11.6%) were Group 2-PH due to left heart disease; twenty-three patients (14.0%) were Group 3-PH due to chronic lung disease; thirty-four patients (20.7%) were Group 4-PH due to chronic thromboembolic lung disease, and five patients (3.0%) were Group 5-PH. Among Group 1-PH, twenty-five (30%) had idiopathic, twenty-seven (33%) had connective tissue disease, twenty-six (31%) had congenital heart disease, and five patients (6%) had porto-pulmonary hypertension. The median follow-up was 55.6 months. Most of the patients were started on dual then sequentially escalated to triple combination therapy. The 1-, 3- and 5-year cumulative probabilities of survival for Group 1-PH were 86% (95% CI, 75-92%), 69% (95% CI, 54-80%) and 69% (95% CI, 54-80%)., Conclusions: This is the first registry of Group 1-PH from a single tertiary referral center in the UAE. Our cohort was younger with a higher percentage of patients with congenital heart disease compared to cohorts from Western countries but similar to registries from other Asian countries. Mortality is comparable to other major registries. Adopting the new guideline recommendations and improving the availability and adherence to medications are likely to play a significant role in improving outcomes in the future.
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- 2023
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30. Management of Heart Failure in Patients With Diabetes Mellitus in the UAE: A Call to Action.
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Sabbour H and Ahmad A
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- Humans, Hypoglycemic Agents adverse effects, Hospitalization, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Heart Failure diagnosis, Heart Failure drug therapy, Heart Failure epidemiology
- Abstract
Background: Heart failure (HF) is an important adverse outcome of diabetes mellitus (DM) with high rates of mortality and HF-related hospitalizations. The risk of HF is 2 times higher in patients with DM compared to those without DM. Due to under-recognition and underdiagnoses, HF is often a neglected outcome in the diabetic population. There is a dearth of data regarding the true prevalence of HF and the management protocols for diabetic patients at risk of HF in the UAE and the Middle East. This lacuna in the information has led to the inception of this "call to action" paper, which identifies the gaps in the true prevalence of HF and describes the importance of early diagnosis and appropriate management of HF in the Middle East., Methodology: An advisory board meeting was convened and a group of key opinion leaders and experts in cardiology and endocrinology assembled to describe the prevalence, diagnosis, and management of HF in diabetes patients and to present a "call to action" in the UAE and Middle East scenario. After the group discussion, key expert opinions were formulated and "call to action" recommendations were proposed., Conclusion: This "call to action" is mainly based on the available evidence from the literature and the experts' clinical experience. Based on the new evidence from various cardiovascular outcome trials, the "call to action" highlights a series of collaborative learning regarding the role of newer antidiabetic therapies like sodium-glucose cotransporter-2 inhibitors in the prevention and management of HF. This "call to action" intends to serve as a guide for physicians, including primary healthcare providers, in their management of diabetic patients with HF.
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- 2023
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31. Prevalence of Cardiovascular Risk Factors and 10-Years Risk for Coronary Heart Disease in the United Arab Emirates.
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Shehab A, Bakir S, Sabbour H, Elnour AA, Mahmeed WA, Salam AM, and Kholy DE
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- Adult, Humans, Young Adult, Middle Aged, Aged, Risk Factors, United Arab Emirates epidemiology, Cross-Sectional Studies, Prevalence, Cholesterol, Heart Disease Risk Factors, Adenosine Triphosphate, Cardiovascular Diseases etiology, Coronary Disease epidemiology, Coronary Disease complications, Coronary Disease prevention & control
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Background: In the United Arab Emirates (UAE), cardiovascular diseases (CVDs) are the leading cause of mortality, and the incidence of premature coronary heart diseases (CHDs) is about 10-15 years earlier than that in people of western countries., Aim: The current cross-sectional study aims to describe the prevalence of CVD risk factors and estimate the 10-years risk for CHDs in the population of Abu Dhabi, UAE., Objective: The main objective was to report the 10-years risk for CHD in a sample of the UAE population., Methods: We have analyzed the dataset from the Abu Dhabi Screening Program for Cardiovascular Risk Markers (AD-SALAMA), a population-based cross-sectional survey conducted between 2009 and 2015 (a sample of 1002, 20 to 79 years old without CVDs or diabetes)., Results: 18.0% of our sample have had hypertension (HTN), 26.3% were current smokers, 33% have had total cholesterol ≥200 mg/dL, 55.0% have had non-high-density lipoprotein (non-HDL) levels ≥130 mg/dL, 33.1% have had low-density lipoprotein cholesterol (LDL-C) levels ≥130 mg/dL, calculated by β-quantification as 112.3 ± 47.1 mg/dL. 66.8% were overweight or obese, and 46.2% had a sedentary lifestyle. Nearly 85% of our sample has had one or more major cardiovascular risk factors. The estimated 10-year risk of cardiovascular disease according to different risk assessment tools was as follows: 7.1% according to the national cholesterol education program Framingham risk score (FRAM-ATP), 2.9% according to Pooled Cohort Risk Assessment Equation (PCRAE) , 1.4% according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and 1.1% according to Reynolds Risk Score. Despite the fact that our sample population have had exhibited major risk factors, the above-mentioned international scoring systems underestimate the 10-year risk of cardiovascular diseases, given the high prevalence at younger ages., Conclusion: The proportion of modifiable risk factors has been found to be high in the UAE population, and the majority of them have had one or more risk factors with a higher 10-years risk for CHDs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2023
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32. Physician Knowledge and Awareness About Cardiac Amyloidosis in the Middle East and Gulf Region.
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Al Badarin F, Al-Humood K, Bader F, Alsaid S, Sulaiman K, Alzadjali M, Sabbour H, Shehab A, Bazargani N, and Perlini S
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Competing Interests: Pfizer Gulf supported creation of the electronic version of the survey through collaboration with Innovacom. Pfizer Gulf did not influence data collection, analysis, or interpretation, nor did it contribute to the writing or editorial review of the manuscript. No honoraria were provided for authorship. Dr Al Badarin has served on an advisory board for Pfizer Gulf. Dr Sabbour has received speaker fees from Pfizer Gulf, AstraZeneca, and Novartis (all honoraria are donated to local charities). Dr Perlini has received honoraria and travel fees from Pfizer, Novartis, and Alnylam; and has received a research grant from Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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- 2022
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33. Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations.
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Sonmez A, Sabbour H, Echtay A, Rahmah AM, Alhozali AM, Al Sabaan FS, Haddad FH, Iraqi H, Elebrashy I, Assaad SN, Bayat Z, Osar Siva Z, and Hassanein M
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- Africa, Northern epidemiology, Humans, Hypoglycemic Agents therapeutic use, Middle East epidemiology, Referral and Consultation, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
The upsurge of type 2 diabetes mellitus is a major public health concern in the Middle East and North Africa (MENA) and Africa (AFR) region, with cardiorenal complications (CRCs) being the predominant cause of premature morbidity and mortality. High prevalence of cardiometabolic risk factors, lack of awareness among patients and physicians, deficient infrastructure, and economic constraints lead to a cascade of CRCs at a significantly earlier age in MENA and AFR. In this review, we present consensus recommendations by experts in MENA and AFR, highlighting region-specific challenges and potential solutions for management of CRCs. Health professionals who understand sociocultural barriers can significantly increase patient awareness and encourage health-seeking behavior through simple educational tools. Increasing physician knowledge on early identification of CRCs and personalized treatment based on risk stratification, alongside optimum glycemic control, can mitigate therapeutic inertia. Early diagnosis of high-risk people with regular and systematic monitoring of cardiorenal parameters, development of region-specific care pathways for timely referral to specialists, followed by guideline-recommended care with novel antidiabetics are imperative. Adherence to guideline-recommended care can catalyze utilization of sodium glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with demonstrated cardiorenal benefits-thus paving the way for overcoming care gaps in a cost-effective manner. Leveraging digital technology like electronic medical records can help generate real-world data and provide insights on voids in adoption of newer antidiabetic medications. A patient-centric approach, collaborative care among physicians from different specialties, alongside involvement of policy makers are key for improving patient outcomes and quality of care in MENA and AFR., (© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.)
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- 2022
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34. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East: 2021 update.
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Alsayed N, Almahmeed W, Alnouri F, Al-Waili K, Sabbour H, Sulaiman K, Zubaid M, Ray KK, and Al-Rasadi K
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- Cholesterol, LDL, Consensus, Humans, Hypolipidemic Agents therapeutic use, Risk Factors, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Dyslipidemias diagnosis, Dyslipidemias drug therapy, Dyslipidemias epidemiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
- Abstract
Background and Aims: Disorders of plasma lipids remain key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) in the Middle East and are estimated to increase more dramatically in the next decade than in any other global region except Africa. This statement is an update to the 2016 consensus clinical recommendations for the management of plasma lipid disorders in the Middle East, following the evaluation of newer cholesterol-lowering agents in randomised controlled cardiovascular outcome trials, as well as the publication of revised international guidelines., Methods: A multidisciplinary panel of regional experts was convened to update the consensus clinical recommendations for the management of plasma lipids in the Middle East. The recommendations constructed in 2016 were reviewed against emerging research since publication., Results: Newly developed Middle East ASCVD risk categories were established using the multiple risk group categories from the recently updated international guidelines and the epidemiological evidence from the Gulf Region. These consensus recommendations support a more intensive reduction of LDL-C across cardiovascular risk categories. Alongside low-density lipoprotein cholesterol, we recommend non-high-density lipoprotein cholesterol as a primary treatment target. Lifestyle modifications remain the first-line treatment recommendation for all patients. The first-line pharmacological treatment in patients with dyslipidaemia is statin therapy, with a number of second-line agents available. The selection of a second lipid-lowering agent for combination therapy with statin should be based on the lipid-lowering target of the patient. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. New therapies have emerged from research that found positive outcomes in reducing low-density lipoprotein cholesterol levels. The initial results of these newly researched drugs strongly indicate their inclusion as future therapies in dyslipidaemia management in the Middle East., Conclusions: These updated consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East., (Copyright © 2021. Published by Elsevier B.V.)
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- 2022
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35. From Clinical Clues to Final Diagnosis: The Return of Detective Work to Clinical Medicine in Cardiac Amyloidosis.
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Sabbour H, Hasan KY, Al Badarin F, Alibazoglu H, Rivard AL, Romany I, and Perlini S
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Cardiac amyloidosis is frequently misdiagnosed, denying patients the opportunity for timely and appropriate management of the disease. The purpose of this review and case studies is to raise awareness of the diagnostic "red flags" associated with cardiac amyloidosis and the currently available non-invasive strategies for diagnosis. The review focuses on the identification of one of the two main types of cardiac amyloidosis, transthyretin amyloid cardiomyopathy, and non-invasive tools to distinguish this from light-chain amyloidosis. A diagnostic algorithm centered around the use of non-invasive imaging and laboratory analysis is presented. The algorithm generates four differential diagnoses for patients presenting with signs and symptoms consistent with cardiac amyloidosis. Case examples are presented, representing the four potential outcomes of diagnosis using the algorithm. The review provides a guide on how to recognize the often-overlooked presentations of this disease in clinical practice. Non-invasive imaging techniques and diagnostic tools that do not require the involvement of a specialty center have allowed for the improved diagnosis of cardiac amyloidosis. Timely diagnosis of this life-threatening disease is essential for optimal management and it is imperative that clinicians have a high index of suspicion for patients presenting with "red flag" symptoms., Competing Interests: HS, HA, and FA reports personal fees from Pfizer Gulf FZ LLC, outside the submitted work. IR was a full-time employee of Pfizer Gulf LLC. This work was supported by Pfizer Gulf FZ LLC. Pfizer provided funding for the editorial assistance in the development of the manuscript. Neither honoraria nor payments were made for authorship. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Sabbour, Hasan, Al Badarin, Alibazoglu, Rivard, Romany and Perlini.)
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- 2021
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36. Familial Hypercholesterolemia in the Arabian Gulf Region: Clinical results of the Gulf FH Registry.
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Alhabib KF, Al-Rasadi K, Almigbal TH, Batais MA, Al-Zakwani I, Al-Allaf FA, Al-Waili K, Zadjali F, Alghamdi M, Alnouri F, Awan Z, Kinsara AJ, AlQudaimi A, Almahmeed W, Sabbour H, Traina M, Atallah B, Al-Jarallah M, AlSarraf A, AlSayed N, Amin H, and Altaradi H
- Subjects
- Bahrain epidemiology, Cholesterol, LDL metabolism, Ezetimibe therapeutic use, Female, Humans, Hyperlipoproteinemia Type II drug therapy, Hyperlipoproteinemia Type II metabolism, Kuwait epidemiology, Male, Middle Aged, Oman epidemiology, Prevalence, Registries, Risk Factors, Saudi Arabia epidemiology, Serine Endopeptidases metabolism, United Arab Emirates epidemiology, Hyperlipoproteinemia Type II epidemiology
- Abstract
Background and Aims: Familial hypercholesterolemia (FH) is a common autosomal dominant disorder that can result in premature atherosclerotic cardiovascular disease (ASCVD). Limited data are available worldwide about the prevalence and management of FH. Here, we aimed to estimate the prevalence and management of patients with FH in five Arabian Gulf countries (Saudi Arabia, Oman, United Arab Emirates, Kuwait, and Bahrain)., Methods: The multicentre, multinational Gulf FH registry included adults (≥18 years old) recruited from outpatient clinics in 14 tertiary-care centres across five Arabian Gulf countries over the last five years. The Gulf FH registry had four phases: 1- screening, 2- classification based on the Dutch Lipid Clinic Network, 3- genetic testing, and 4- follow-up., Results: Among 34,366 screened patient records, 3713 patients had suspected FH (mean age: 49±15 years; 52% women) and 306 patients had definite or probable FH. Thus, the estimated FH prevalence was 0.9% (1:112). Treatments included high-intensity statin therapy (34%), ezetimibe (10%), and proprotein convertase subtilisin/kexin type 9 inhibitors (0.4%). Targets for low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol were achieved by 12% and 30%, respectively, of patients at high ASCVD risk, and by 3% and 6%, respectively, of patients at very high ASCVD risk (p <0.001; for both comparisons)., Conclusions: This snap-shot study was the first to show the high estimated prevalence of FH in the Arabian Gulf region (about 3-fold the estimated prevalence worldwide), and is a "call-to-action" for further confirmation in future population studies. The small proportions of patients that achieved target LDL-C values implied that health care policies need to implement nation-wide screening, raise FH awareness, and improve management strategies for FH., Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: KA reports grants from Sanofi during the conduct of the study and other funs from Sanofi, Abbott, and MSD outside the submitted work; NA reports personal fees from Sanofi, Aegerion, Merck Sharp, Abbott, AstraZeneca, Pfizer, and Amgen outside the submitted work; HS reports personal fees from Sanofi and Amgen outside the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.
- Published
- 2021
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37. The Gulf Familial Hypercholesterolemia Registry (Gulf FH): Design, Rationale and Preliminary Results.
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Al-Rasadi K, Alhabib KF, Al-Allaf F, Al-Waili K, Al-Zakwani I, AlSarraf A, Almahmeed W, AlSayed N, Alghamdi M, Batais MA, Almigbal TH, Alnouri F, Kinsara A, Hammouda A, Awan Z, Kary H, Elamin OA, Zadjali F, Al-Jarallah M, Shehab A, Sabbour H, Amin H, and Altaradi H
- Subjects
- Adolescent, Adult, Aged, Biomarkers blood, Cross-Sectional Studies, Female, Genetic Predisposition to Disease, Humans, Hyperlipoproteinemia Type II diagnosis, Hyperlipoproteinemia Type II genetics, Hyperlipoproteinemia Type II therapy, Longitudinal Studies, Male, Middle Aged, Middle East epidemiology, Phenotype, Preliminary Data, Prevalence, Prognosis, Registries, Research Design, Retrospective Studies, Risk Factors, Time Factors, Young Adult, Hyperlipoproteinemia Type II epidemiology, Lipids blood
- Abstract
Aim: To determine the prevalence, genetic characteristics, current management and outcomes of familial hypercholesterolaemia (FH) in the Gulf region., Methods: Adult (18-70 years) FH patients were recruited from 9 hospitals and centres across 5 Arabian Gulf countries. The study was divided into 4 phases and included patients from 3 different categories. In phase 1, suspected FH patients (category 1) were collected according to the lipid profile and clinical data obtained through hospital record systems. In phase 2, patients from category 2 (patients with a previous clinical diagnosis of FH) and category 1 were stratified into definitive, probable and possible FH according to the Dutch Lipid Clinic Network criteria. In phase 3, 500 patients with definitive and probable FH from categories 1 and 2 will undergo genetic testing for 4 common FH genes. In phase 4, these 500 patients with another 100 patients from category 3 (patients with previous genetic diagnosis of FH) will be followed for 1 year to evaluate clinical management and cardiovascular outcomes. The Gulf FH cohort was screened from a total of 34,366 patients attending out-patient clinics., Results: The final Gulf FH cohort consisted of 3,317 patients (mean age: 47±12 years, 54% females). The number of patients with definitive FH is 203. In this initial phase of the study, the prevalence of (probable and definite) FH is 1/232., Conclusion: The prevalence of FH in the adult population of the Arabian Gulf region is high. The Gulf FH registry, a first-of-a-kind multi-national study in the Middle East region, will help in improving underdiagnosis and undertreatment of FH in the region., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2020
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38. Consensus recommendations for management of patients with type 2 diabetes mellitus and cardiovascular diseases.
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Bashier A, Bin Hussain A, Abdelgadir E, Alawadi F, Sabbour H, and Chilton R
- Abstract
The recent American Diabetes Association and the European Association for the Study of Diabetes guideline mentioned glycaemia management in type 2 diabetes mellitus (T2DM) patients with cardiovascular diseases (CVDs); however, it did not cover the treatment approaches for patients with T2DM having a high risk of CVD, and treatment and screening approaches for CVDs in patients with concomitant T2DM. This consensus guideline undertakes the data obtained from all the cardiovascular outcome trials (CVOTs) to propose approaches for the T2DM management in presence of CV comorbidities. For patients at high risk of CVD, metformin is the drug of choice to manage the T2DM to achieve a patient specific HbA1c target. In case of established CVD, a combination of glucagon-like peptide-1 receptor agonist with proven CV benefits is recommended along with metformin, while for chronic kidney disease or heart failure, a sodium-glucose transporter proteins-2 inhibitor with proven benefit is advised. This document also summarises various screening and investigational approaches for the major CV events with their accuracy and specificity along with the treatment guidance to assist the healthcare professionals in selecting the best management strategies for every individual. Since lifestyle modification and management plays an important role in maintaining the effectiveness of the pharmacological therapies, authors of this consensus recommendation have also briefed on the patient-centric non-pharmacological management of T2DM and CVD., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)
- Published
- 2019
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39. Incidental finding of pulmonary artery aneurysm revealing a congenital heart defect.
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Dougherty KAD, Elkaissi M, Sabbour H, and Farha S
- Subjects
- Aneurysm complications, Aneurysm diagnostic imaging, Ductus Arteriosus, Patent complications, Familial Primary Pulmonary Hypertension complications, Humans, Incidental Findings, Middle Aged, Pulmonary Artery diagnostic imaging, Pulmonary Disease, Chronic Obstructive complications, Tomography, X-Ray Computed, Aneurysm pathology, Ductus Arteriosus, Patent diagnosis, Pulmonary Artery pathology
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2019
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40. Practical perspectives on the use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with nonvalvular atrial fibrillation: A view from the Middle East and North Africa.
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Hersi AS, Alhebaishi YS, Hamoui O, Hassan T, Khalifa Hamad A, Magdy M, Sabbour H, and Shaheen S
- Abstract
Clinical guidelines for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) are available from several international cardiology associations. Patients with NVAF in the Middle East and North Africa (MENA) region present unique challenges and opportunities related to differences in geography, practice patterns, and patient demographics that are as yet unaddressed in practice guidelines. This review aims to offer a practical perspective on the management of NVAF in patients in MENA and draws on evidence-based guidelines as well as real-world evidence and expert opinion. The literature was searched for relevant original research articles, systematic reviews, meta-analyses, and guideline recommendations addressing the prevention of stroke in patients with NVAF with a focus on issues relevant to the MENA region. Guideline recommendations, best practices, and expert opinion were discussed and agreed on by a working group consisting of cardiologists from across the MENA region. The incidence of stroke secondary to atrial fibrillation in patients across the MENA region is higher than rates reported globally, and this might be attributed to a higher incidence of vascular risk factors and underuse of anticoagulants in patients in the MENA. The available evidence supports the established role of non-vitamin K antagonist oral anticoagulants (NOACs) in the prevention of stroke in patients with NVAF. There is a consistent body of clinical trial and real-world evidence supporting their efficacy for stroke prevention in NVAF, with more favorable bleeding risk profiles relative to vitamin K antagonists, such that guidelines now recommend the use of NOACs in preference over vitamin K antagonists. There are important opportunities to improve the management of NVAF outcomes for patients with NVAF by applying evidence-based guidelines for stroke prevention. Growing experience with NOACs in the MENA region will help guide patient selection and elucidate optimal dosing strategies to maximize the clinical benefits of the NOACs.
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- 2018
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41. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East.
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Al Sayed N, Al Waili K, Alawadi F, Al-Ghamdi S, Al Mahmeed W, Al-Nouri F, Al Rukhaimi M, Al-Rasadi K, Awan Z, Farghaly M, Hassanein M, Sabbour H, Zubaid M, and Barter P
- Subjects
- Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases therapy, Case-Control Studies, Dyslipidemias diagnosis, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypolipidemic Agents therapeutic use, Middle East epidemiology, Risk Factors, Consensus, Disease Management, Dyslipidemias epidemiology, Dyslipidemias therapy, Practice Guidelines as Topic standards
- Abstract
Background: Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions., Methods: A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations., Results: The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia., Conclusions: These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East., (Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.)
- Published
- 2016
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42. The Gulf Implantable Cardioverter-defibrillator Registry: Rationale, Methodology, and Implementation.
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Alsheikh-Ali AA, Hersi AS, Hamad AK, Al Fagih AR, Al-Samadi FM, Almusaad AM, Bokhari FA, Al-Kandari F, Al-Ghamdi BS, Al Rawahi N, Asaad N, Alkaabi S, Daoulah A, Zaky HA, Elhag O, Al Hebaishi YS, Sweidan R, Alanazi H, Chase D, Sabbour H, Al Meheiri M, Al Abri I, Amin M, Dagriri K, Ahmed AO, Shafquat A, and Khan SH
- Abstract
Background: The implantable cardioverter-defibrillator (ICD) is effective in the prevention of sudden cardiac death in high-risk patients. Little is known about ICD use in the Arabian Gulf. We designed a study to describe the characteristics and outcomes of patients receiving ICDs in the Arab Gulf region., Methods: Gulf ICD is a prospective, multi-center, multinational, and observational study. All adult patients 18 years or older, receiving a de novo ICD implant and willing to sign a consent form will be eligible. Data on baseline characteristics, ICD indication, procedure and programing, in-hospital, and 1-year outcomes will be collected. Target enrollment is 1500 patients, which will provide adequate precision across a wide range of expected event rates., Results: Fifteen centers in six countries are enrolling patients (Saudi Arabia, United Arab Emirates, Kuwait, Oman, Bahrain, and Qatar). Two-thirds of the centers have dedicated electrophysiology laboratories, and in almost all centers ICDs are implanted exclusively by electrophysiologists. Nearly three-quarters of the centers reported annual ICD implant volumes of ≤150 devices, and pulse generator replacements constitute <30% of implants in the majority of centers. Enrollment started in December 2013, and accrual rate increased as more centers entered the study reaching an average of 98 patients per month., Conclusions: Gulf ICD is the first prospective, observational, multi-center, and multinational study of the characteristics and, the outcomes of patients receiving ICDs in the Arab Gulf region. The study will provide valuable insights into the utilization of and outcomes related to ICD therapy in the Gulf region.
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- 2015
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43. Identification and Treatment of Patients with Homozygous Familial Hypercholesterolaemia: Information and Recommendations from a Middle East Advisory Panel.
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Al-Ashwal A, Alnouri F, Sabbour H, Al-Mahfouz A, Al-Sayed N, Razzaghy-Azar M, Al-Allaf F, Al-Waili K, Banerjee Y, Genest J, Santos RD, and Al-Rasadi K
- Subjects
- Ezetimibe therapeutic use, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hyperlipoproteinemia Type II diagnosis, Hyperlipoproteinemia Type II epidemiology, Middle East, Plasma Exchange methods, Prevalence, Risk Factors, Anticholesteremic Agents therapeutic use, Hyperlipoproteinemia Type II therapy, Practice Guidelines as Topic
- Abstract
We present clinical practice guidelines for the diagnosis and treatment of homozygous familial hypercholesterolaemia (HoFH) in the Middle East region. While guidelines are broadly applicable in Europe, in the Middle East we experience a range of confounding factors that complicate disease management to a point whereby the European guidance cannot be applied without significant modification. Specifically, for disease prevalence, the Middle East region has an established epidemic of diabetes and metabolic syndrome that can complicate treatment and mask a clinical diagnosis of HoFH. We have also a high incidence of consanguineous marriages, which increase the risk of transmission of recessive and homozygous genetic disorders. This risk is further augmented in autosomal dominant disorders such as familial hypercholesterolaemia (FH), in which a range of defective genes can be transmitted, all of which contribute to the phenotypic expression of the disease. In terms of treatment, we do not have access to lipoprotein apheresis on the same scale as in Europe, and there remains a significant reliance on statins, ezetimibe and the older plasma exchange methods. Additionally, we do not have widespread access to anti-apolipoprotein B therapies and microsomal transfer protein inhibitors. In order to adapt existing global guidance documents on HoFH to the Middle East region, we convened a panel of experts from Oman, Saudi Arabia, UAE, Iran and Bahrain to draft a regional guidance document for HoFH. We also included selected experts from outside the region. This panel statement will form the foundation of a detailed appraisal of the current FH management in the Middle Eastern population and thereby provide a suitable set of guidelines tailored for the region.
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- 2015
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44. Requirements for Achieving and Maintaining Competency in the Implantation and Management of Cardiac Implantable Electrical Devices: A clinical competency statement by the Emirates Cardiac Society.
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Alkaabi S, Elhag O, Sabbour H, and Alsheikh-Ali AA
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- 2013
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45. Cardiac device implant wound closure with 2-octyl cyanoacrylate.
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Pachulski R, Sabbour H, Gupta R, Adkins D, Mirza H, and Cone J
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- Administration, Topical, Aged, Arrhythmias, Cardiac therapy, Cyanoacrylates administration & dosage, Female, Follow-Up Studies, Humans, Male, Retrospective Studies, Surgical Wound Dehiscence etiology, Sutures adverse effects, Time Factors, Tissue Adhesives administration & dosage, Wound Healing, Cyanoacrylates therapeutic use, Defibrillators, Implantable, Prosthesis Implantation adverse effects, Surgical Wound Dehiscence drug therapy, Tissue Adhesives therapeutic use
- Abstract
2-Octyl Cyanoacrylate (2-OCA) is a tissue adhesive developed for skin laceration closure that has not been previously evaluated for cardiac device implant wound closure. We reviewed 460 consecutive device implants with 475 incisions between November 1993 and May 2001. From November 1993 to December 1998, all patients (n 335) had a 3-layer reabsorbable suture closure with the application of topical bacitracin and dressing material. They were advised to avoid exposure to moisture for 10 days. From January 1999 to May 2001, the superficial suture layer was replaced with 2-OCA (n=125). No topical bacitracin or dressing was applied and patients were allowed to shower within 72 hours. The two groups did not differ significantly with respect to age (69 +/- 12 vs 70 +/- 13 years, P=NS), sex (59% vs 62% male, p=NS) or device type (77% vs 68% pacemakers/loop recorders, p=NS). All incisions were evaluated at 24 hours, 7-14 days, and 6-12 weeks postprocedure. The 2-OCA and suture groups did not differ significantly with respect to allergic reaction (0% vs 1.4%, P=NS), cellulitis (0% vs 0.9%, P=NS), and infection requiring explant (0.8% vs 0.3%, P=NS), respectively. Total adverse events occurred in 1 of 125 (0.8%) of the 2-OCA group versus 9 of 350 (2.6%) of the suture group (P=NS). In cardiac device implant closure 2-OCA obviated the need for topical antibiotics and dressing materials while facilitating wound care without increased complications.
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- 2005
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46. Para-Hisian entrainment: a novel pacing maneuver to differentiate orthodromic atrioventricular reentrant tachycardia from atrioventricular nodal reentrant tachycardia.
- Author
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Reddy VY, Jongnarangsin K, Albert CM, Sabbour H, Keane D, Mela T, McGovern B, and Ruskin JN
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- Adolescent, Adult, Aged, Aged, 80 and over, Catheter Ablation, Diagnosis, Differential, Electrophysiologic Techniques, Cardiac, Female, Humans, Male, Middle Aged, Prospective Studies, Tachycardia, Atrioventricular Nodal Reentry therapy, Atrioventricular Node physiopathology, Cardiac Pacing, Artificial methods, Tachycardia, Atrioventricular Nodal Reentry classification, Tachycardia, Atrioventricular Nodal Reentry diagnosis
- Abstract
Introduction: Para-Hisian pacing during sinus rhythm can help to identify the presence of an accessory pathway (AP). In this maneuver, the retrograde activation time and pattern are compared during capture and loss-of-capture of the His bundle while pacing from a para-Hisian position. However, identification of a retrograde AP does not necessitate that it is operative during the tachycardia of interest; conversely, slowly conducting or "distant" bypass tracts may not be identified. We evaluated the utility of entrainment or resetting of tachycardias from the para-Hisian position to help distinguish atrioventricular nodal reentrant tachycardia (AVNRT) from orthodromic atrioventricular tachycardia (AVRT)., Methods and Results: Para-Hisian entrainment/resetting was evaluated in 50 patients: 33 with AVNRT and 17 with AVRT. The maneuvers were performed using a standard quadripolar catheter placed at the His position: low output for right ventricular (RV) capture and high output for both RV and His capture. The retrograde atrial activation sequence, SA interval (interval from stimulus to earliest retrograde atrial activation), and "local" VA interval (interval between the ventricular and atrial electrograms at the site of earliest retrograde atrial activation) were compared between His and His/RV capture. The DeltaSA was > 40 ms in patients with AVNRT and was < 40 ms in all but one patient with AVRT. In concert with the DeltaSA interval, the DeltaVA interval was able to fully define the mechanism of the tachycardia in all patients studied., Conclusion: Para-Hisian entrainment/resetting can determine the course of retrograde conduction operative during narrow complex tachycardias. It is a useful diagnostic maneuver in differentiating AVNRT and orthodromic AVRT.
- Published
- 2003
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