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1. Diagnostic and prognostic utility of bone morphogenetic protein 10 in acute dyspnea: a cohort study

Author

Simonavicius, Justas, Wussler, Desiree, Belkin, Maria, Luening, Karoline, Lopez-Ayala, Pedro, Strebel, Ivo, Shrestha, Samyut, Nowak, Albina, Michou, Eleni, Papachristou, Androniki, Popescu, Codruta, Kozhuharov, Nikola, Sabti, Zaid, Reiffer, Zora, Hennings, Elisa, Zimmermann, Tobias, Diebold, Matthias, Breidthardt, Tobias, and Mueller, Christian

Published
2024
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2. Prognostic Value of Self-Reported Subjective Exercise Capacity in Patients With Acute Dyspnea

Author

Belkin, Maria, Wussler, Desiree, Michou, Eleni, Strebel, Ivo, Kozhuharov, Nikola, Sabti, Zaid, Nowak, Albina, Shrestha, Samyut, Lopez-Ayala, Pedro, Prepoudis, Alexandra, Stefanelli, Sabrina, Schäfer, Ibrahim, Mork, Constantin, Albus, Miriam, Danier, Isabelle, Simmen, Cornelia, Zimmermann, Tobias, Diebold, Matthias, Breidthardt, Tobias, and Mueller, Christian

Published
2023
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3. Activity of the adrenomedullin system to personalise post-discharge diuretic treatment in acute heart failure

Author

Kozhuharov, Nikola, Ng, Leong, Wussler, Desiree, Strebel, Ivo, Sabti, Zaid, Hartmann, Oliver, Eltayeb, Mohamed, Squire, Iain, Nowak, Albina, Rieger, Max, Martin, Jasmin, Michou, Eleni, Stefanelli, Sabrina, Puelacher, Christian, Shrestha, Samyut, Belkin, Maria, Zimmermann, Tobias, Lopez-Ayala, Pedro, Struck, Joachim, Bergmann, Andreas, Mebazaa, Alexandre, Blet, Alice, Gualandro, Danielle Menosi, Breidthardt, Tobias, and Mueller, Christian

Published
2022
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5. Relative hypochromia and mortality in acute heart failure

Author

Kleber, Martina, Kozhuharov, Nikola, Sabti, Zaid, Glatz, Bettina, Isenreich, Rahel, Wussler, Desiree, Nowak, Albina, Twerenbold, Raphael, Badertscher, Patrick, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Nestelberger, Thomas, Boeddinghaus, Jasper, Wildi, Karin, Flores, Dayana, Walter, Joan, Rentsch, Katharina, von Eckardstein, Arnold, Goudev, Assen, Breidthardt, Tobias, and Mueller, Christian

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

Author

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

Published
2019
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7. Incremental diagnostic and prognostic value of the QRS-T angle, a 12-lead ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction

Author

Strebel, Ivo, Twerenbold, Raphael, Wussler, Desiree, Boeddinghaus, Jasper, Nestelberger, Thomas, du Fay de Lavallaz, Jeanne, Abächerli, Roger, Maechler, Patrick, Mannhart, Diego, Kozhuharov, Nikola, Rubini Giménez, Maria, Wildi, Karin, Sazgary, Lorraine, Sabti, Zaid, Puelacher, Christian, Badertscher, Patrick, Keller, Dagmar I., Miró, Òscar, Fuenzalida, Carolina, Calderón, Sofia, Martin-Sanchez, F. Javier, Iglesias, Sergio Lopez, Osswald, Stefan, Mueller, Christian, and Reichlin, Tobias

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

Author

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

Published
2018
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9. Combining high-sensitivity cardiac troponin and B-type natriuretic peptide in the detection of inducible myocardial ischemia

Author

Puelacher, Christian, Wagener, Max, Honegger, Ursina, Assadian, Mustafa, Schaerli, Nicolas, Mueller, Deborah, Strebel, Ivo, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Sabti, Zaid, Sazgary, Lorraine, Badertscher, Patrick, du Fay de Lavallaz, Jeanne, Marbot, Stella, Kaiser, Christoph, Wild, Damian, Zellweger, Michael J., Reichlin, Tobias, and Mueller, Christian

Published
2018
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10. Proenkephalin and prognosis in heart failure with preserved ejection fraction: a GREAT network study

Author

Kanagala, Prathap, Squire, Iain B., Jones, Donald J. L., Cao, Thong Huy, Chan, Daniel C. S., McCann, Gerry, Sandhu, Jatinderpal K., Quinn, Paulene A., McAdam, John, Marsh, Anna-Marie, Davies, Joan E., Struck, Joachim, Bergmann, Andreas, Sabti, Zaid, Twerenbold, Raphael, Herrmann, Thomas, Kozhuharov, Nikola, Mueller, Christian, Ng, Leong L., and On behalf of the GREAT (Global REsearch on Acute Conditions Team) Network

Published
2019
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12. Diagnostic value of ST-segment deviations during cardiac exercise stress testing: Systematic comparison of different ECG leads and time-points

Author

Puelacher, Christian, Wagener, Max, Abächerli, Roger, Honegger, Ursina, Lhasam, Nundsin, Schaerli, Nicolas, Prêtre, Gil, Strebel, Ivo, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Rubini Giménez, Maria, Hillinger, Petra, Wildi, Karin, Sabti, Zaid, Badertscher, Patrick, Cupa, Janosch, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Freese, Michael, Roux, Isabelle, Lohrmann, Jens, Leber, Remo, Osswald, Stefan, Wild, Damian, Zellweger, Michael J., Mueller, Christian, and Reichlin, Tobias

Published
2017
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13. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction

Author

Abächerli, Roger, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Mächler, Patrick, Sassi, Roberto, Rivolta, Massimo W, Roonizi, Ebadollah Kheirati, Mainardi, Luca T, Kozhuharov, Nikola, Rubini Giménez, Maria, Wildi, Karin, Grimm, Karin, Sabti, Zaid, Hillinger, Petra, Puelacher, Christian, Strebel, Ivo, Cupa, Janosch, Badertscher, Patrick, Roux, Isabelle, Schmid, Ramun, Leber, Remo, Osswald, Stefan, Mueller, Christian, and Reichlin, Tobias

Published
2017
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14. Meta-Analysis of Soluble Suppression of Tumorigenicity-2 and Prognosis in Acute Heart Failure

Author

Aimo, Alberto, Vergaro, Giuseppe, Ripoli, Andrea, Bayes-Genis, Antoni, Pascual Figal, Domingo A., de Boer, Rudolf A., Lassus, Johan, Mebazaa, Alexandre, Gayat, Etienne, Breidthardt, Tobias, Sabti, Zaid, Mueller, Christian, Brunner-La Rocca, Hans-Peter, Tang, W.H. Wilson, Grodin, Justin L., Zhang, Yuhui, Bettencourt, Paulo, Maisel, Alan S., Passino, Claudio, Januzzi, James L., and Emdin, Michele

Published
2017
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15. Diagnostic and Prognostic Value of Lead aVR During Exercise Testing in Patients Suspected of Having Myocardial Ischemia

Author

Wagener, Max, Abächerli, Roger, Honegger, Ursina, Schaerli, Nicolas, Prêtre, Gil, Twerenbold, Raphael, Puelacher, Christian, Sunier, Germaine, Reddiess, Philipp, Rubini Gimenez, Maria, Wildi, Karin, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Schmid, Ramun, Leber, Remo, Widmer, Dayana Flores, Shrestha, Samyut, Strebel, Ivo, Wild, Damian, Osswald, Stefan, Zellweger, Michael, Mueller, Christian, and Reichlin, Tobias

Published
2017
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16. Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality

Author

Badertscher, Patrick, Strebel, Ivo, Honegger, Ursina, Schaerli, Nicolas, Mueller, Deborah, Puelacher, Christian, Wagener, Max, Abächerli, Roger, Walter, Joan, Sabti, Zaid, Sazgary, Lorraine, Marbot, Stella, du Fay de Lavallaz, Jeanne, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Kozhuharov, Nikola, Breidthardt, Tobias, Shrestha, Samyut, Flores, Dayana, Schumacher, Carmela, Wild, Damian, Osswald, Stefan, Zellweger, Michael J., Mueller, Christian, and Reichlin, Tobias

Published
2018
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17. Safety and efficacy of the 0 h/3 h protocol for rapid rule out of myocardial infarction

Author

Wildi, Karin, Nelles, Berit, Twerenbold, Raphael, Rubini Giménez, Maria, Reichlin, Tobias, Singeisen, Hélène, Druey, Sophie, Haaf, Philip, Sabti, Zaid, Hillinger, Petra, Jaeger, Cedric, Campodarve, Isabel, Kreutzinger, Philip, Puelacher, Christian, Moreno Weidmann, Zoraida, Gugala, Mathias, Pretre, Gilles, Doerflinger, Stephanie, Wagener, Max, Stallone, Fabio, Freese, Michael, Stelzig, Claudia, Rentsch, Katharina, Bassetti, Stefano, Bingisser, Roland, Osswald, Stefan, and Mueller, Christian

Published
2016
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18. The Electrocardiogram After Transcatheter Aortic Valve Replacement Determines the Risk for Post-Procedural High-Degree AV Block and the Need for Telemetry Monitoring

Author

Toggweiler, Stefan, Stortecky, Stefan, Holy, Erik, Zuk, Katarzyna, Cuculi, Florim, Nietlispach, Fabian, Sabti, Zaid, Suciu, Raluca, Maier, Willibald, Jamshidi, Peiman, Maisano, Francesco, Windecker, Stephan, Kobza, Richard, Wenaweser, Peter, Lüscher, Thomas F., and Binder, Ronald K.

Published
2016
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19. Characterization of the observe zone of the ESC 2015 high-sensitivity cardiac troponin 0 h/1 h-algorithm for the early diagnosis of acute myocardial infarction

Author

Nestelberger, Thomas, Wildi, Karin, Boeddinghaus, Jasper, Twerenbold, Raphael, Reichlin, Tobias, Giménez, Maria Rubini, Puelacher, Christian, Jaeger, Cedric, Grimm, Karin, Sabti, Zaid, Hillinger, Petra, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Pinck, Florentina, Lopez, Beatriz, Salgado, Emilio, Miró, Òscar, Bingisser, Roland, Lohrmann, Jens, Osswald, Stefan, and Mueller, Christian

Published
2016
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20. Comprehensive vasodilatation in women with acute heart failure: Novel insights from the GALACTIC randomized controlled trial.

Author

Wussler, Desiree, Belkin, Maria, Maeder, Micha T., Walter, Joan, Shrestha, Samyut, Kupska, Karolina, Stierli, Michelle, Flores, Dayana, Kozhuharov, Nikola, Gualandro, Danielle Menosi, de Oliveira Junior, Mucio Tavares, Sabti, Zaid, Noveanu, Markus, Socrates, Thenral, Bayés‐Genis, Antoni, Sionis, Alessandro, Simon, Patrick, Michou, Eleni, Gujer, Samuel, and Gori, Tommaso

Subjects
HEART failure, RANDOMIZED controlled trials, ALDOSTERONE antagonists, VASODILATION, SYSTOLIC blood pressure, HEART failure patients, VENTRICULAR ejection fraction
Abstract

Aims: Sex‐specific differences in acute heart failure (AHF) are both relevant and underappreciated. Therefore, it is crucial to evaluate the risk/benefit ratio and the implementation of novel AHF therapies in women and men separately. Methods and results: We performed a pre‐defined sex‐specific analysis in AHF patients randomized to a strategy of early intensive and sustained vasodilatation versus usual care in an international, multicentre, open‐label, blinded endpoint trial. Inclusion criteria were AHF with increased plasma concentrations of natriuretic peptides, systolic blood pressure ≥100 mmHg, and plan for treatment in a general ward. Among 781 eligible patients, 288 (37%) were women. Women were older (median 83 vs. 76 years), had a lower body weight (median 64.5 vs. 77.6 kg) and lower estimated glomerular filtration rate (median 48 vs. 54 ml/min/1.73 m2). The primary endpoint, a composite of all‐cause mortality or rehospitalization for AHF at 180 days, showed a significant interaction of treatment strategy and sex (p for interaction = 0.03; hazard ratio adjusted for female sex 1.62, 95% confidence interval 1.05–2.50; p = 0.03). The combined endpoint occurred in 53 women (38%) in the intervention group and in 35 (24%) in the usual care group. The implementation of rapid up‐titration of renin–angiotensin–aldosterone system (RAAS) inhibitors was less successful in women versus men in the overall cohort and in patients with heart failure with reduced ejection fraction (median discharge % target dose in patients randomized to intervention: 50% in women vs. 75% in men). Conclusion: Rapid up‐titration of RAAS inhibitors was less successfully implemented in women possibly explaining their higher rate of all‐cause mortality and rehospitalization for AHF. Clinical Trial Registration: ClinicalTrials.gov, unique identifier NCT00512759. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Quantifying inflammation using interleukin‐6 for improved phenotyping and risk stratification in acute heart failure

Author

Michou, Eleni, primary, Wussler, Desiree, additional, Belkin, Maria, additional, Simmen, Cornelia, additional, Strebel, Ivo, additional, Nowak, Albina, additional, Kozhuharov, Nikola, additional, Shrestha, Samyut, additional, Lopez‐Ayala, Pedro, additional, Sabti, Zaid, additional, Mork, Constantin, additional, Diebold, Matthias, additional, Péquignot, Tiffany, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Gualandro, Danielle M., additional, Breidthardt, Tobias, additional, and Mueller, Christian, additional

Published
2023
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22. Early diagnosis of acute myocardial infarction in patients with mild elevations of cardiac troponin

Author

Boeddinghaus, Jasper, Reichlin, Tobias, Nestelberger, Thomas, Twerenbold, Raphael, Meili, Yvette, Wildi, Karin, Hillinger, Petra, Giménez, Maria Rubini, Cupa, Janosch, Schumacher, Lukas, Schubera, Marie, Badertscher, Patrick, Corbière, Sydney, Grimm, Karin, Puelacher, Christian, Sabti, Zaid, Widmer, Dayana Flores, Schaerli, Nicolas, Kozhuharov, Nikola, Shrestha, Samyut, Bürge, Tobias, Mächler, Patrick, Büchi, Michael, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Morawiec, Beata, Kawecki, Damian, Ganovská, Eva, Parenica, Jiri, Lohrmann, Jens, Buser, Andreas, Keller, Dagmar I., Osswald, Stefan, and Mueller, Christian

Published
2017
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23. Gender-specific uncertainties in the diagnosis of acute coronary syndrome

Author

Hillinger, Petra, Twerenbold, Raphael, Wildi, Karin, Rubini Gimenez, Maria, Jaeger, Cedric, Boeddinghaus, Jasper, Nestelberger, Thomas, Grimm, Karin, Reichlin, Tobias, Stallone, Fabio, Puelacher, Christian, Sabti, Zaid, Kozhuharov, Nikola, Honegger, Ursina, Ballarino, Paola, Miro, Oscar, Denhaerynck, Kris, Ekrem, Temizel, Kohler, Claudia, Bingisser, Roland, Osswald, Stefan, and Mueller, Christian

Published
2017
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24. Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Author

van der Linden, Noreen, Wildi, Karin, Twerenbold, Raphael, Pickering, John W., Than, Martin, Cullen, Louise, Greenslade, Jaimi, Parsonage, William, Nestelberger, Thomas, Boeddinghaus, Jasper, Badertscher, Patrick, Rubini Giménez, Maria, Klinkenberg, Lieke J.J., Bekers, Otto, Schöni, Aline, Keller, Dagmar I., Sabti, Zaid, Puelacher, Christian, Cupa, Janosch, Schumacher, Lukas, Kozhuharov, Nikola, Grimm, Karin, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Strebel, Ivo, Miró, Òscar, Rentsch, Katharina, Morawiec, Beata, Kawecki, Damian, Kloos, Wanda, Lohrmann, Jens, Richards, A. Mark, Troughton, Richard, Pemberton, Christopher, Osswald, Stefan, van Dieijen-Visser, Marja P., Mingels, Alma M., Reichlin, Tobias, Meex, Steven J.R., and Mueller, Christian

Published
2018
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25. Response by Kaier et al to Letter Regarding Article, “Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction”

Author

Kaier, Thomas E., Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Rubini Giménez, Maria, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Flores Widmer, Dayana, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, and Mueller, Christian

Published
2018
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26. Direct Comparison of the 0/1h and 0/3h Algorithms for Early Rule-Out of Acute Myocardial Infarction

Author

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

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

Author

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

Published
2018
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28. 0/1-Hour Triage Algorithm for Myocardial Infarction in Patients With Renal Dysfunction

Author

Twerenbold, Raphael, Badertscher, Patrick, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Puelacher, Christian, Sabti, Zaid, Rubini Gimenez, Maria, Tschirky, Sandra, du Fay de Lavallaz, Jeanne, Kozhuharov, Nikola, Sazgary, Lorraine, Mueller, Deborah, Breidthardt, Tobias, Strebel, Ivo, Flores Widmer, Dayana, Shrestha, Samyut, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Parenica, Jiri, Geigy, Nicolas, Keller, Dagmar I., Rentsch, Katharina, von Eckardstein, Arnold, Osswald, Stefan, Reichlin, Tobias, and Mueller, Christian

Published
2018
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29. Development and validation of a decision support tool for the diagnosis of acute heart failure: systematic review, meta-analysis, and modelling study

Author

Lee, Kuan Ken, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R. J., Pinto, Yigal, Gaggin, Hanna K., Wiemer, Jan C., Möckel, Martin, Rutten, Joost H. W., van den Meiracker, Anton H., Gargani, Luna, Pugliese, Nicola R., Pemberton, Christopher, Ibrahim, Irwani, Gegenhuber, Alfons, Mueller, Thomas, Neumaier, Michael, Behnes, Michael, Akin, Ibrahim, Bombelli, Michele, Grassi, Guido, Nazerian, Peiman, Albano, Giovanni, Bahrmann, Philipp, Newby, David E., Japp, Alan G., Tsanas, Athanasios, Shah, Anoop S. V., Richards, A. Mark, McMurray, John J. V., Mueller, Christian, Januzzi, James L., Mills, Nicholas L., on behalf of the CoDE-HF investigators, Cardiology, ACS - Heart failure & arrhythmias, Internal Medicine, Lee, K, Doudesis, D, Anwar, M, Astengo, F, Chenevier-Gobeaux, C, Claessens, Y, Wussler, D, Kozhuharov, N, Strebel, I, Sabti, Z, Defilippi, C, Seliger, S, Moe, G, Fernando, C, Bayes-Genis, A, van Kimmenade, R, Pinto, Y, Gaggin, H, Wiemer, J, Möckel, M, Rutten, J, van den Meiracker, A, Gargani, L, Pugliese, N, Pemberton, C, Ibrahim, I, Gegenhuber, A, Mueller, T, Neumaier, M, Behnes, M, Akin, I, Bombelli, M, Grassi, G, Nazerian, P, Albano, G, Bahrmann, P, Newby, D, Japp, A, Tsanas, A, Shah, A, Richards, A, Mcmurray, J, Mueller, C, Januzzi, J, and Mills, N

Subjects
Heart Failure, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Predictive Value of Test, General Medicine, Biomarker, Peptide Fragments, Diagnosis, Differential, Prospective Studie, Observational Studies as Topic, Peptide Fragment, SDG 3 - Good Health and Well-being, Predictive Value of Tests, Natriuretic Peptide, Brain, Humans, Prospective Studies, Biomarkers, Human
Abstract

ObjectivesTo evaluate the diagnostic performance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) thresholds for acute heart failure and to develop and validate a decision support tool that combines NT-proBNP concentrations with clinical characteristics.DesignIndividual patient level data meta-analysis and modelling study.SettingFourteen studies from 13 countries, including randomised controlled trials and prospective observational studies.ParticipantsIndividual patient level data for 10 369 patients with suspected acute heart failure were pooled for the meta-analysis to evaluate NT-proBNP thresholds. A decision support tool (Collaboration for the Diagnosis and Evaluation of Heart Failure (CoDE-HF)) that combines NT-proBNP with clinical variables to report the probability of acute heart failure for an individual patient was developed and validated.Main outcome measureAdjudicated diagnosis of acute heart failure.ResultsOverall, 43.9% (4549/10 369) of patients had an adjudicated diagnosis of acute heart failure (73.3% (2286/3119) and 29.0% (1802/6208) in those with and without previous heart failure, respectively). The negative predictive value of the guideline recommended rule-out threshold of 300 pg/mL was 94.6% (95% confidence interval 91.9% to 96.4%); despite use of age specific rule-in thresholds, the positive predictive value varied at 61.0% (55.3% to 66.4%), 73.5% (62.3% to 82.3%), and 80.2% (70.9% to 87.1%), in patients aged 75 years, respectively. Performance varied in most subgroups, particularly patients with obesity, renal impairment, or previous heart failure. CoDE-HF was well calibrated, with excellent discrimination in patients with and without previous heart failure (area under the receiver operator curve 0.846 (0.830 to 0.862) and 0.925 (0.919 to 0.932) and Brier scores of 0.130 and 0.099, respectively). In patients without previous heart failure, the diagnostic performance was consistent across all subgroups, with 40.3% (2502/6208) identified at low probability (negative predictive value of 98.6%, 97.8% to 99.1%) and 28.0% (1737/6208) at high probability (positive predictive value of 75.0%, 65.7% to 82.5%) of having acute heart failure.ConclusionsIn an international, collaborative evaluation of the diagnostic performance of NT-proBNP, guideline recommended thresholds to diagnose acute heart failure varied substantially in important patient subgroups. The CoDE-HF decision support tool incorporating NT-proBNP as a continuous measure and other clinical variables provides a more consistent, accurate, and individualised approach.Study registrationPROSPERO CRD42019159407.

Published
2022
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30. Development and validation of a decision support tool for the diagnosis of acute heart failure: Systematic review, meta-analysis, and modelling study

Author

Lee, K, Doudesis, D, Anwar, M, Astengo, F, Chenevier-Gobeaux, C, Claessens, Y, Wussler, D, Kozhuharov, N, Strebel, I, Sabti, Z, Defilippi, C, Seliger, S, Moe, G, Fernando, C, Bayes-Genis, A, van Kimmenade, R, Pinto, Y, Gaggin, H, Wiemer, J, Möckel, M, Rutten, J, van den Meiracker, A, Gargani, L, Pugliese, N, Pemberton, C, Ibrahim, I, Gegenhuber, A, Mueller, T, Neumaier, M, Behnes, M, Akin, I, Bombelli, M, Grassi, G, Nazerian, P, Albano, G, Bahrmann, P, Newby, D, Japp, A, Tsanas, A, Shah, A, Richards, A, Mcmurray, J, Mueller, C, Januzzi, J, Mills, N, Lee, Kuan Ken, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R J, Pinto, Yigal, Gaggin, Hanna K, Wiemer, Jan C, Möckel, Martin, Rutten, Joost H W, van den Meiracker, Anton H, Gargani, Luna, Pugliese, Nicola R, Pemberton, Christopher, Ibrahim, Irwani, Gegenhuber, Alfons, Mueller, Thomas, Neumaier, Michael, Behnes, Michael, Akin, Ibrahim, Bombelli, Michele, Grassi, Guido, Nazerian, Peiman, Albano, Giovanni, Bahrmann, Philipp, Newby, David E, Japp, Alan G, Tsanas, Athanasios, Shah, Anoop S V, Richards, A Mark, McMurray, John J V, Mueller, Christian, Januzzi, James L, Mills, Nicholas L, Lee, K, Doudesis, D, Anwar, M, Astengo, F, Chenevier-Gobeaux, C, Claessens, Y, Wussler, D, Kozhuharov, N, Strebel, I, Sabti, Z, Defilippi, C, Seliger, S, Moe, G, Fernando, C, Bayes-Genis, A, van Kimmenade, R, Pinto, Y, Gaggin, H, Wiemer, J, Möckel, M, Rutten, J, van den Meiracker, A, Gargani, L, Pugliese, N, Pemberton, C, Ibrahim, I, Gegenhuber, A, Mueller, T, Neumaier, M, Behnes, M, Akin, I, Bombelli, M, Grassi, G, Nazerian, P, Albano, G, Bahrmann, P, Newby, D, Japp, A, Tsanas, A, Shah, A, Richards, A, Mcmurray, J, Mueller, C, Januzzi, J, Mills, N, Lee, Kuan Ken, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R J, Pinto, Yigal, Gaggin, Hanna K, Wiemer, Jan C, Möckel, Martin, Rutten, Joost H W, van den Meiracker, Anton H, Gargani, Luna, Pugliese, Nicola R, Pemberton, Christopher, Ibrahim, Irwani, Gegenhuber, Alfons, Mueller, Thomas, Neumaier, Michael, Behnes, Michael, Akin, Ibrahim, Bombelli, Michele, Grassi, Guido, Nazerian, Peiman, Albano, Giovanni, Bahrmann, Philipp, Newby, David E, Japp, Alan G, Tsanas, Athanasios, Shah, Anoop S V, Richards, A Mark, McMurray, John J V, Mueller, Christian, Januzzi, James L, and Mills, Nicholas L

Abstract

Objectives: To evaluate the diagnostic performance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) thresholds for acute heart failure and to develop and validate a decision support tool that combines NT-proBNP concentrations with clinical characteristics. Design: Individual patient level data meta-analysis and modelling study. Setting: Fourteen studies from 13 countries, including randomised controlled trials and prospective observational studies. Participants: Individual patient level data for 10 369 patients with suspected acute heart failure were pooled for the meta-analysis to evaluate NT-proBNP thresholds. A decision support tool (Collaboration for the Diagnosis and Evaluation of Heart Failure (CoDE-HF)) that combines NT-proBNP with clinical variables to report the probability of acute heart failure for an individual patient was developed and validated. Main outcome measure: Adjudicated diagnosis of acute heart failure. Results: Overall, 43.9% (4549/10 369) of patients had an adjudicated diagnosis of acute heart failure (73.3% (2286/3119) and 29.0% (1802/6208) in those with and without previous heart failure, respectively). The negative predictive value of the guideline recommended rule-out threshold of 300 pg/mL was 94.6% (95% confidence interval 91.9% to 96.4%); despite use of age specific rule-in thresholds, the positive predictive value varied at 61.0% (55.3% to 66.4%), 73.5% (62.3% to 82.3%), and 80.2% (70.9% to 87.1%), in patients aged [removed]75 years, respectively. Performance varied in most subgroups, particularly patients with obesity, renal impairment, or previous heart failure. CoDE-HF was well calibrated, with excellent discrimination in patients with and without previous heart failure (area under the receiver operator curve 0.846 (0.830 to 0.862) and 0.925 (0.919 to 0.932) and Brier scores of 0.130 and 0.099, respectively). In patients without previous heart failure, the diagnostic performance was consistent across all subgroups

Published
2022

31. Development and validation of a decision support tool for the diagnosis of acute heart failure:systematic review, meta-analysis, and modelling study

Author

Lee, Kuan Ken, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R J, Pinto, Yigal, Gaggin, Hanna K, Wiemer, Jan C, Möckel, Martin, Rutten, Joost H W, van den Meiracker, Anton H, Gargani, Luna, Pugliese, Nicola R, Pemberton, Christopher, Ibrahim, Irwani, Gegenhuber, Alfons, Mueller, Thomas, Neumaier, Michael, Behnes, Michael, Akin, Ibrahim, Bombelli, Michele, Grassi, Guido, Nazerian, Peiman, Albano, Giovanni, Bahrmann, Philipp, Newby, David E, Japp, Alan G, Tsanas, Athanasios, Shah, Anoop S V, Richards, A Mark, McMurray, John J V, Mueller, Christian, Januzzi, James L, Mills, Nicholas L, Lee, Kuan Ken, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R J, Pinto, Yigal, Gaggin, Hanna K, Wiemer, Jan C, Möckel, Martin, Rutten, Joost H W, van den Meiracker, Anton H, Gargani, Luna, Pugliese, Nicola R, Pemberton, Christopher, Ibrahim, Irwani, Gegenhuber, Alfons, Mueller, Thomas, Neumaier, Michael, Behnes, Michael, Akin, Ibrahim, Bombelli, Michele, Grassi, Guido, Nazerian, Peiman, Albano, Giovanni, Bahrmann, Philipp, Newby, David E, Japp, Alan G, Tsanas, Athanasios, Shah, Anoop S V, Richards, A Mark, McMurray, John J V, Mueller, Christian, Januzzi, James L, and Mills, Nicholas L

Abstract

Abstract:Objectives: To evaluate the diagnostic performance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) thresholds for acute heart failure and to develop and validate a decision support tool that combines NT-proBNP concentrations with clinical characteristics. Design: Individual patient level data meta-analysis and modelling study. Setting: Fourteen studies from 13 countries, including randomised controlled trials and prospective observational studies. Participants: Individual patient level data for 10 369 patients with suspected acute heart failure were pooled for the meta-analysis to evaluate NT-proBNP thresholds. A decision support tool (Collaboration for the Diagnosis and Evaluation of Heart Failure (CoDE-HF)) that combines NT-proBNP with clinical variables to report the probability of acute heart failure for an individual patient was developed and validated. Main outcome measure: Adjudicated diagnosis of acute heart failure. Results: Overall, 43.9% (4549/10 369) of patients had an adjudicated diagnosis of acute heart failure (73.3% (2286/3119) and 29.0% (1802/6208) in those with and without previous heart failure, respectively). The negative predictive value of the guideline recommended rule-out threshold of 300 pg/mL was 94.6% (95% confidence interval 91.9% to 96.4%); despite use of age specific rule-in thresholds, the positive predictive value varied at 61.0% (55.3% to 66.4%), 73.5% (62.3% to 82.3%), and 80.2% (70.9% to 87.1%), in patients aged <50 years, 50-75 years, and >75 years, respectively. Performance varied in most subgroups, particularly patients with obesity, renal impairment, or previous heart failure. CoDE-HF was well calibrated, with excellent discrimination in patients with and without previous heart failure (area under the receiver operator curve 0.846 (0.830 to 0.862) and 0.925 (0.919 to 0.932) and Brier scores of 0.130 and 0.099, respectively). In patients without previous heart failure, the diagnostic performance was co

Published
2022

32. Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome

Author

Chapman, Andrew R., Lee, Kuan Ken, McAllister, David A., Cullen, Louise, Greenslade, Jaimi H., Parsonage, William, Worster, Andrew, Kavsak, Peter A., Blankenberg, Stefan, Neumann, Johannes, Söerensen, Nils A., Westermann, Dirk, Buijs, Madelon M., Verdel, Gerard J. E., Pickering, John W., Than, Martin P., Twerenbold, Raphael, Badertscher, Patrick, Sabti, Zaid, Mueller, Christian, Anand, Atul, Adamson, Philip, Strachan, Fiona E., Ferry, Amy, Sandeman, Dennis, Gray, Alasdair, Body, Richard, Keevil, Brian, Carlton, Edward, Greaves, Kim, Korley, Frederick K., Metkus, Thomas S., Sandoval, Yader, Apple, Fred S., Newby, David E., Shah, Anoop S. V., and Mills, Nicholas L.

Published
2017
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33. Abstract 13566: High-Sensitivity Cardiac Troponin I at Presentation in Patients With Suspected Acute Coronary Syndrome

Author

Chapman, Andrew R, Lee, Kuan Ken, McAllister, David A, Cullen, Louise, Greenslade, Jaimi H, Parsonage, William, Worster, Andrew, Kavsak, Peter, Blankenberg, Stefan, Neumann, Johannes, Söerensen, Nils, Westermann, Dirk, Buijs, Madelon M, Verdel, Gerard J, Pickering, John W, Than, Martin P, Twerenbold, Raphael, Badertscher, Patrick, Sabti, Zaid, Mueller, Christian, Anand, Atul, Adamson, Philip, Strachan, Fiona E, Gray, Alasdair, Body, Richard, Keevil, Brian, Carlton, Edward, Greaves, Kim, Korley, Frederick K, Metkus, Thomas, Sandoval, Yader, Apple, Fred S, Newby, David, Shah, Anoop, and Mills, Nicholas L

Published
2017

34. Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction

Author

Kaier, Thomas E., Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Giménez, Maria Rubini, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Widmer, Dayana Flores, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, and Mueller, Christian

Published
2017
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35. Direct Comparison of 4 Very Early Rule-Out Strategies for Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin I

Author

Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Wildi, Karin, Badertscher, Patrick, Cupa, Janosch, Bürge, Tobias, Mächler, Patrick, Corbière, Sydney, Grimm, Karin, Giménez, Maria Rubini, Puelacher, Christian, Shrestha, Samyut, Flores Widmer, Dayana, Fuhrmann, Jakob, Hillinger, Petra, Sabti, Zaid, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Morawiec, Beata, Kawecki, Damian, Ganovská, Eva, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I., Osswald, Stefan, Reichlin, Tobias, and Mueller, Christian

Published
2017
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36. Impact of haemoconcentration during acute heart failure therapy on mortality and its relationship with worsening renal function

Author

Breidthardt, Tobias, Weidmann, Zoraida Moreno, Twerenbold, Raphael, Gantenbein, Claudine, Stallone, Fabio, Rentsch, Katharina, Rubini Gimenez, Maria, Kozhuharov, Nikola, Sabti, Zaid, Breitenbücher, Dominik, Wildi, Karin, Puelacher, Christian, Honegger, Ursina, Wagener, Max, Schumacher, Carmela, Hillinger, Petra, Osswald, Stefan, and Mueller, Christian

Published
2017
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37. An algorithm for rule-in and rule-out of acute myocardial infarction using a novel troponin I assay

Author

Lindahl, Bertil, Jernberg, Tomas, Badertscher, Patrick, Boeddinghaus, Jasper, Eggers, Kai M, Frick, Mats, Rubini Gimenez, Maria, Linder, Rickard, Ljung, Lina, Martinsson, Arne, Melki, Dina, Nestelberger, Thomas, Rentsch, Katharina, Reichlin, Tobias, Sabti, Zaid, Schubera, Marie, Svensson, Per, Twerenbold, Raphael, Wildi, Karin, and Mueller, Christian

Published
2017
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38. Development and validation of a decision support tool for the diagnosis of acute heart failure: systematic review, meta-analysis, and modelling study

Author

Lee, Kuan Ken, primary, Doudesis, Dimitrios, additional, Anwar, Mohamed, additional, Astengo, Federica, additional, Chenevier-Gobeaux, Camille, additional, Claessens, Yann-Erick, additional, Wussler, Desiree, additional, Kozhuharov, Nikola, additional, Strebel, Ivo, additional, Sabti, Zaid, additional, deFilippi, Christopher, additional, Seliger, Stephen, additional, Moe, Gordon, additional, Fernando, Carlos, additional, Bayes-Genis, Antoni, additional, van Kimmenade, Roland R J, additional, Pinto, Yigal, additional, Gaggin, Hanna K, additional, Wiemer, Jan C, additional, Möckel, Martin, additional, Rutten, Joost H W, additional, van den Meiracker, Anton H, additional, Gargani, Luna, additional, Pugliese, Nicola R, additional, Pemberton, Christopher, additional, Ibrahim, Irwani, additional, Gegenhuber, Alfons, additional, Mueller, Thomas, additional, Neumaier, Michael, additional, Behnes, Michael, additional, Akin, Ibrahim, additional, Bombelli, Michele, additional, Grassi, Guido, additional, Nazerian, Peiman, additional, Albano, Giovanni, additional, Bahrmann, Philipp, additional, Newby, David E, additional, Japp, Alan G, additional, Tsanas, Athanasios, additional, Shah, Anoop S V, additional, Richards, A Mark, additional, McMurray, John J V, additional, Mueller, Christian, additional, Januzzi, James L, additional, and Mills, Nicholas L, additional

Published
2022
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40. Activity of the adrenomedullin system to personalise post-discharge diuretic treatment in acute heart failure

Author

Kozhuharov, Nikola, primary, Ng, Leong, additional, Wussler, Desiree, additional, Strebel, Ivo, additional, Sabti, Zaid, additional, Hartmann, Oliver, additional, Eltayeb, Mohamed, additional, Squire, Iain, additional, Nowak, Albina, additional, Rieger, Max, additional, Martin, Jasmin, additional, Michou, Eleni, additional, Stefanelli, Sabrina, additional, Puelacher, Christian, additional, Shrestha, Samyut, additional, Belkin, Maria, additional, Zimmermann, Tobias, additional, Lopez-Ayala, Pedro, additional, Struck, Joachim, additional, Bergmann, Andreas, additional, Mebazaa, Alexandre, additional, Blet, Alice, additional, Gualandro, Danielle Menosi, additional, Breidthardt, Tobias, additional, and Mueller, Christian, additional

Published
2021
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41. Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure

Author

Kozhuharov, Nikola, Wussler, Desiree, Kaier, Thomas, Strebel, Ivo, Shrestha, Samyut, Flores, Dayana, Nowak, Albina, Sabti, Zaid, Nestelberger, Thomas, Zimmermann, Tobias, Walter, Joan, Belkin, Maria, Michou, Eleni, Lopez Ayala, Pedro, Gualandro, Danielle M., Keller, Dagmar I., Goudev, Assen, Breidthardt, Tobias, Mueller, Christian, Marber, Michael, and Basel V. Investigators

Subjects
medicine.medical_specialty, medicine.drug_class, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Troponin T, Interquartile range, Internal medicine, Natriuretic Peptide, Brain, Natriuretic peptide, Humans, Medicine, Prospective Studies, Heart Failure, Creatinine, Ejection fraction, business.industry, Hazard ratio, Natriuretic Peptide, C-Type, Stroke Volume, Emergency department, Prognosis, medicine.disease, Peptide Fragments, Confidence interval, DNA-Binding Proteins, chemistry, Heart failure, Cardiology, Carrier Proteins, Cardiology and Cardiovascular Medicine, business, Biomarkers, Transcription Factors
Abstract

AIMS Cardiac myosin-binding protein C (cMyC) seems to be even more sensitive in the quantification of cardiomyocyte injury vs. high-sensitivity cardiac troponin, and may therefore have diagnostic and prognostic utility. METHODS AND RESULTS In a prospective multicentre diagnostic study, cMyC, high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma concentrations were measured in blinded fashion in patients presenting to the emergency department with acute dyspnoea. Two independent cardiologists centrally adjudicated the final diagnosis. Diagnostic accuracy for acute heart failure (AHF) was quantified by the area under the receiver operating characteristic curve (AUC). All-cause mortality within 360 days was the prognostic endpoint. Among 1083 patients eligible for diagnostic analysis, 51% had AHF. cMyC concentrations at presentation were higher among AHF patients vs. patients with other final diagnoses [72 (interquartile range, IQR 39-156) vs. 22 ng/L (IQR 12-42), P

Published
2021

43. Mortality and pathophysiology of acute kidney injury according to time of occurrence in acute heart failure

Author

Diebold, Matthias, Kozhuharov, Nikola, Wussler, Desiree, Strebel, Ivo, Sabti, Zaid, Flores, Dayana, Shrestha, Samyut, Martin, Jasmin, Staub, Daniel, Venge, Per, Mueller, Christian, Breidthardt, Tobias, Diebold, Matthias, Kozhuharov, Nikola, Wussler, Desiree, Strebel, Ivo, Sabti, Zaid, Flores, Dayana, Shrestha, Samyut, Martin, Jasmin, Staub, Daniel, Venge, Per, Mueller, Christian, and Breidthardt, Tobias

Abstract

Aims Acute kidney injury (AKI) during acute heart failure (AHF) is common and associated with increased morbidity and mortality. The underlying pathophysiological mechanism appears to have prognostic relevance; however, the differentiation of true, structural AKI from hemodynamic pseudo‐AKI remains a clinical challenge. Methods and results The Basics in Acute Shortness of Breath Evaluation Study (NCT01831115) prospectively enrolled adult patients presenting with AHF to the emergency department. Mortality of patients was prospectively assessed. Haemoconcentration, transglomerular pressure gradient (n = 231) and tubular injury patterns (n = 253) were evaluated to investigate pathophysiological mechanisms underlying AKI timing (existing at presentation vs. developing during in‐hospital period). Of 1643 AHF patients, 755 patients (46%) experienced an episode of AKI; 310 patients (19%; 41% of AKI patients) presented with community‐acquired AKI (CA‐AKI), 445 patients (27%; 59% of AKI patients) developed in‐hospital AKI. CA‐AKI but not in‐hospital AKI was associated with higher mortality compared with no‐AKI (adjusted hazard ratio 1.32 [95%‐CI 1.01–1.74]; P = 0.04). Independent of AKI timing, haemoconcentration was associated with a lower two‐year mortality. Transglomerular pressure gradient at presentation was significantly lower in CA‐AKI compared to in‐hospital AKI and no‐AKI (P < 0.01). Urinary NGAL ratio concentrations were significantly higher in CA‐AKI compared to in‐hospital AKI (P < 0.01) or no‐AKI (P < 0.01). Conclusions CA‐AKI but not in‐hospital AKI is associated with increased long‐term mortality and marked by decreased transglomerular pressure gradient and tubular injury, probably reflecting prolonged tubular ischemia due to reno‐venous congestion. Adequate decongestion, as assessed by haemoconcentration, is associated with lower long‐term mortality independent of AKI timing.

Published
2020
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44. Diagnostic and prognostic values of the QRS-T angle in patients with suspected acute decompensated heart failure

Author

Sweda, Romy, Sabti, Zaid, Strebel, Ivo, Kozhuharov, Nikola, Wussler, Desiree, Shrestha, Samyut, Flores, Dayana, Badertscher, Patrick, Lopez-Ayala, Pedro, Zimmermann, Tobias, Michou, Eleni, Gualandro, Danielle M, Häberlin, Andreas, Tanner, Hildegard, Keller, Dagmar I, Nowak, Albina, Pfister, Otmar, Breidthardt, Tobias, Mueller, Christian, Reichlin, Tobias, Sweda, Romy, Sabti, Zaid, Strebel, Ivo, Kozhuharov, Nikola, Wussler, Desiree, Shrestha, Samyut, Flores, Dayana, Badertscher, Patrick, Lopez-Ayala, Pedro, Zimmermann, Tobias, Michou, Eleni, Gualandro, Danielle M, Häberlin, Andreas, Tanner, Hildegard, Keller, Dagmar I, Nowak, Albina, Pfister, Otmar, Breidthardt, Tobias, Mueller, Christian, and Reichlin, Tobias

Abstract

AIMS The aim of this study was to investigate the diagnostic and prognostic utility of the QRS-T angle, an electrocardiogram (ECG) marker quantifying depolarization-repolarization heterogeneity, in patients with suspected acute decompensated heart failure (ADHF). METHODS AND RESULTS We prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of ADHF. The QRS-T angle was automatically derived from a standard 12-lead ECG recorded at presentation. The primary diagnostic endpoint was a final adjudicated diagnosis of ADHF. The primary prognostic endpoint was all-cause mortality during 2 years of follow-up. Among the 1915 patients enrolled, those with higher QRS-T angles were older, were more commonly male, and had a higher rate of co-morbidities such as arterial hypertension, coronary artery disease, or chronic kidney disease. ADHF was the final adjudicated diagnosis in 1140 (60%) patients. The QRS-T angle in patients with ADHF was significantly larger than in patients with non-cardiac causes of dyspnoea {median 110° [inter-quartile range (IQR) 46-156°] vs. median 33° [IQR 15-57°], P < 0.001}. The diagnostic accuracy of the QRS-T angle as quantified by the area under the receiver operating characteristic curve (AUC) was 0.75 [95% confidence interval (CI) 0.73-0.77, P < 0.001], which was inferior to N-terminal pro-B-type natriuretic peptide (AUC 0.93, 95% CI 0.92-0.94, P < 0.001), but similar to that of high-sensitivity troponin T (AUC 0.78, 95% CI 0.76-0.80, P = 0.09). The AUC of the QRS-T angle for discrimination between ADHF and non-cardiac dyspnoea remained similarly high in subgroups of patients known to be diagnostically challenging, including patients older than 75 years [0.71 (95% CI 0.67-0.74)], renal failure [0.79 (95% CI 0.71-0.87)], and atrial fibrillation at presentation [0.68 (95% CI 0.60-0.76)]. Mortality rates according to QRS-T angle tertiles were 4%, 6%, and 10% after 30 days (P < 0.001) and 24%, 31%, and

Published
2020

45. Development and validation of a decision support tool for the diagnosis of acute heart failure: systematic review, meta-analysis, and modelling study.

Author

Kuan Ken Lee, Doudesis, Dimitrios, Anwar, Mohamed, Astengo, Federica, Chenevier-Gobeaux, Camille, Claessens, Yann-Erick, Wussler, Desiree, Kozhuharov, Nikola, Strebel, Ivo, Sabti, Zaid, deFilippi, Christopher, Seliger, Stephen, Moe, Gordon, Fernando, Carlos, Bayes-Genis, Antoni, van Kimmenade, Roland R. J., Pinto, Yigal, Gaggin, Hanna K., Wiemer, Jan C., and Möckel, Martin

Subjects
EXPERIMENTAL design, MEDICAL databases, META-analysis, MEDICAL information storage & retrieval systems, RESEARCH methodology, RESEARCH methodology evaluation, SYSTEMATIC reviews, DESCRIPTIVE statistics, PEPTIDE hormones, MEDLINE, HEART failure, ACUTE diseases
Published
2022
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46. Mortality and pathophysiology of acute kidney injury according to time of occurrence in acute heart failure

Author

Diebold, Matthias, primary, Kozhuharov, Nikola, additional, Wussler, Desiree, additional, Strebel, Ivo, additional, Sabti, Zaid, additional, Flores, Dayana, additional, Shrestha, Samyut, additional, Martin, Jasmin, additional, Staub, Daniel, additional, Venge, Per, additional, Mueller, Christian, additional, and Breidthardt, Tobias, additional

Published
2020
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47. Diagnostic and prognostic values of the QRS‐T angle in patients with suspected acute decompensated heart failure

Author

Sweda, Romy, primary, Sabti, Zaid, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Wussler, Desiree, additional, Shrestha, Samyut, additional, Flores, Dayana, additional, Badertscher, Patrick, additional, Lopez‐Ayala, Pedro, additional, Zimmermann, Tobias, additional, Michou, Eleni, additional, Gualandro, Danielle M., additional, Häberlin, Andreas, additional, Tanner, Hildegard, additional, Keller, Dagmar I., additional, Nowak, Albina, additional, Pfister, Otmar, additional, Breidthardt, Tobias, additional, Mueller, Christian, additional, and Reichlin, Tobias, additional

Published
2020
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48. Effect of a strategy of comprehensive vasodilation vs usual care on mortality and heart failure rehospitalization among patients With acute heart failure: the GALACTIC randomized clinical trial

Author

Kozhuharov, Nikola, Goudev, Assen, Flores, Dayana, Maeder, Micha T, Walter, Joan, Shrestha, Samyut, Gualandro, Danielle Menosi, de Oliveira Junior, Mucio Tavares, Sabti, Zaid, Müller, Beat, Noveanu, Markus, Socrates, Thenral, Ziller, Ronny, Bayés-Genís, Antoni, Sionis, Alessandro, Simon, Patrick, Michou, Eleni, Gujer, Samuel, Gori, Tommaso, Wenzel, Philip, Pfister, Otmar, Conen, David, Kapos, Ioannis, Kobza, Richard, Rickli, Hans, Breidthardt, Tobias, Münzel, Thomas, Erne, Paul, Mueller, Christian, GALACTIC Investigators, et al, University of Zurich, and Mueller, Christian

Subjects
10209 Clinic for Cardiology, 610 Medicine & health, 2700 General Medicine
Published
2019
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49. Clinical Utility of Procalcitonin in the Diagnosis of Pneumonia

Author

Wussler, Desiree, Kozhuharov, Nikola, Tavares Oliveira, Mucio, Bossa, Aline, Sabti, Zaid, Nowak, Albina, Murray, Karsten, du Fay de Lavallaz, Jeanne, Badertscher, Patrick, Twerenbold, Raphael, Shrestha, Samyut, Flores, Dayana, Nestelberger, Thomas, Walter, Joan, Boeddinghaus, Jasper, Zimmermann, Tobias, Koechlin, Luca, von Eckardstein, Arnold, Breidthardt, Tobias, Mueller, Christian, University of Zurich, and Mueller, Christian

Subjects
10265 Clinic for Endocrinology and Diabetology, 610 Medicine & health, 1308 Clinical Biochemistry, 2704 Biochemistry (medical), 10038 Institute of Clinical Chemistry
Published
2019
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50. Prospective validation of N-terminal pro B-type natriuretic peptide cut-off concentrations for the diagnosis of acute heart failure

Author

Kozhuharov, Nikola, Sabti, Zaid, Wussler, Desiree, Nowak, Albina, Badertscher, Patrick, Twerenbold, Raphael, Wildi, Karin, Stallone, Fabio, Vogt, Fabian, Hilti, Jonas, Puelacher, Christian, Du Fay De Lavallaz, Jeanne, Shrestha, Samyut, Flores, Dayana, Nestelberger, Thomas, Koechlin, Luca, Boeddinghaus, Jasper, Zimmermann, Tobias, Walter, Joan, Schumacher, Carmela, Rentsch, Katharina, Von Eckardstein, Arnold, Keller, Dagmar I, Goudev, Assen, Pfister, Otmar, Breidthardt, Tobias, and Mueller, Christian

Published
2019
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