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3. The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands

Author

van den Boogert, T. P. W., Claessen, B. E. P. M., Boekholdt, S. M., Leiner, T., Vliegenthart, R., Schuiling, S. F., Timmer, J. R., Bekkers, S. C. A. M., Voskuil, M., Siebelink, H. J., van Es, W., Lamb, H. J., Prokop, M., Damman, P., Stoker, J., Willems, H. C., Henriques, J. P., and Planken, R. N.

Published
2021
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9. The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands

Author

Circulatory Health, Researchgr. Cardiovasculaire Radiologie, MS Radiologie, Team Medisch, van den Boogert, T P W, Claessen, B E P M, Boekholdt, S M, Leiner, T, Vliegenthart, R, Schuiling, S F, Timmer, J R, Bekkers, S C A M, Voskuil, M, Siebelink, H J, van Es, W, Lamb, H J, Prokop, M, Damman, P, Stoker, J, Willems, H C, Henriques, J P, Planken, R N, Circulatory Health, Researchgr. Cardiovasculaire Radiologie, MS Radiologie, Team Medisch, van den Boogert, T P W, Claessen, B E P M, Boekholdt, S M, Leiner, T, Vliegenthart, R, Schuiling, S F, Timmer, J R, Bekkers, S C A M, Voskuil, M, Siebelink, H J, van Es, W, Lamb, H J, Prokop, M, Damman, P, Stoker, J, Willems, H C, Henriques, J P, and Planken, R N

Published
2021

13. P3126Immediate versus delayed revascularization in patients with transient ST-elevation myocardial infarction: 1-year follow-up of the randomized clinical TRANSIENT trial

Author

Janssens, G N, primary, Van Der Hoeven, N W, additional, Lemkes, J S, additional, Everaars, H, additional, Van De Ven, P, additional, Marques, K M J, additional, Nap, A, additional, Van Leeuwen, M A H, additional, Appelman, Y E A, additional, Brinckman, S L, additional, Timmer, J R, additional, Meuwissen, M, additional, Van Der Weerdt, A, additional, Nijveldt, R, additional, and Van Royen, N, additional

Published
2019
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17. Poster Session 2 : Monday 4 May 2015, 08

Author

Bouyoucef, S E, Uusitalo, V, Kamperidis, V, De Graaf, M A, Maaniitty, T, Stenstrom, I, Broersen, A, Scholte, A J, Saraste, A, Bax, J J, Knuuti, J, Furuhashi, T, Moroi, M, Awaya, T, Masai, H, Minakawa, M, Kunimasa, T, Fukuda, H, Sugi, K, Berezin, A, Kremzer, A, Clerc, O F, Kaufmann, B, Possner, M, Liga, R, Vontobel, J, Mikulicic, F, Graeni, C, Benz, D C, Kaufmann, P A, Buechel, R B, Ferreira, Mjv, Cunha, M J, Albuquerque, A, Ramos, D, Costa, G, Lima, J, Pego, M, Peix, A, Cisneros, L, Cabrera, L O, Padron, K, Rodriguez, L, Heres, F, Carrillo, R, Mena, E, Fernandez, Y, Huizing, E D, Van Dijk, J D, Van Dalen, J A, Timmer, J R, Ottervanger, J P, Slump, C H, Jager, P L, Venuraju, S, Jeevarethinam, A, Yerramasu, A, Atwal, S, Mehta, V S, Lahiri, A, Arjonilla Lopez, A, Calero Rueda, M J, Gallardo, G, Fernandez-Cuadrado, J, Hernandez Aceituno, D, Sanchez Hernandez, J, Yoshida, H, Mizukami, A, Matsumura, A, Smettei, O, Abazid, R, Sayed, S, Mlynarska, A, Mlynarski, R, Golba, K, Sosnowski, M, Winther, S, Svensson, M, Jorgensen, H S, Bouchelouche, K, Gormsen, L C, Holm, N R, Botker, H E, Ivarsen, P R, Bottcher, M, Cortes, C M, Aramayo G, E N, Daicz, M, Casuscelli, J F, Alaguibe, E D, Neira Sepulveda, A, Cerda, M, Ganum, G E, Embon, M, Vigne, J, Enilorac, B, Lebasnier, A, Valancogne, L, Peyronnet, D, Manrique, A, Agostini, D, Menendez, D, Rajpal, S, Kocherla, C, Acharya, M, Reddy, P, Sazonova, I, Ilushenkova, Yun, Batalov, R E, Rogovskaya, Y V, Lishmanov, Y B, Popov, S V, Varlamova, N V, Prado Diaz, S, Jimenez Rubio, C, Gemma, D, Refoyo Salicio, E, Valbuena Lopez, S C, Moreno Yanguela, M, Torres, M, Fernandez-Velilla, M, Lopez-Sendon, J L, Guzman Martinez, G, Puente, A, Rosales, S, Martinez, C, Cabada, M, Melendez, G M, Ferreira, R, Gonzaga, A, Santos, J, Vijayan, S, Smith, Smg, Smith, M, Muthusamy, R, Takeishi, Y, Oikawa, M, Goral, J L, Napoli, J, Montana, O R, Damico, A C, Quiroz, M C, Damico, A E, Forcada, P J, Schmidberg, J M, Zucchiatti, N E, Olivieri, D B, Dumo, A, Ruano, S, Rakhit, R, Davar, J, Nair, D, Cohen, M, Darko, D, Yokota, S, Maas, Ahe, Mouden, M, Knollema, S, Sanja Mazic, S M, Lazovic, B, Marina Djelic, Mdj, Jelena Suzic Lazic, J S, Tijana Acimovic, T A, Milica Deleva, M D, Vesnina, Z H, Zafrir, N, Bental, T, Mats, I, Solodky, A, Gutstein, A, Hasid, Y, Belzer, D, Kornowski, R, Ben Said, Rim, Ben Mansour, N, Ibn Haj Amor, H, Chourabi, C, Hagui, A, Fehri, W, Hawala, H, Shugushev, Z, Patrikeev, A, Maximkin, D, Chepurnoy, A, Kallianpur, V, Mambetov, A, Dokshokov, G, Teresinska, A, Wozniak, O, Maciag, A, Wnuk, J, Dabrowski, A, Czerwiec, A, Jezierski, J, Biernacka, K, Robinson, J, Prosser, J, Cheung, Gsm, Allan, S, Mcmaster, G, Reid, S, Tarbuck, A, Martin, W, Queiroz, R C, Falcao, A, Giorgi, McP, Imada, R, Nogueira, S A, Chalela, W A, Kalil Filho, R, Meneghetti, W A, Matveev, V V, Bubyenov, A S, Podzolkov, V I, Baranovich, V, Faibushevich, A, Kolzhecova, Y, Volkova, O, Fernandez, J, Lopez, G, Dondi, M, Paez, D, Butcher, Cjt, Reyes, E, Al-Housni, M B, Green, R, Santiago, H, Ghiotto, F, Hinton-Taylor, S, Pottle, A, Mason, M, Underwood, S R, Casans Tormo, I, Diaz-Exposito, R, Plancha-Burguera, E, Elsaban, K, Alsakhri, Hijji, Yoshinaga, K, Ochi, N, Tomiyama, Y, Katoh, C, Inoue, M, Nishida, M, Suzuki, E, Manabe, O, Ito, Y M, Tamaki, N, Tahilyani, A, Jafary, Fahim, Ho Hee Hwa, H H, Ozdemir, S, Kirilmaz, B, Barutcu, A, Tan, Y Z, Celik, F, Sakgoz, S, Cabada Gamboa, M, Puente Barragan, A, Morales Vitorino, N, Medina Servin, M A, Hindorf, C, Akil, S, Hedeer, F, Jogi, J, Engblom, H, Martire, V D, Pis Diez, E R, Martire, M V, Portillo, D O, Hoff, C M, Balche, A, Majgaard, J, Tolbod, L P, Harms, H J, Soerensen, J, Froekiaer, J, Nudi, F, Neri, G, Procaccini, E, Pinto, A, Vetere, M, Biondi-Zoccai, G, Soares, J, Do Val, R, Oliveira, M A, Meneghetti, J C, Tekabe, Y, Anthony, T, Li, Q, Schmidt, A M, Johnson, L, Groenman, M, Tarkia, M, Kakela, M, Halonen, P, Kiviniemi, T, Pietila, M, Yla-Herttuala, S, Roivainen, A, Nekolla, S, Swirzek, S, Higuchi, T, Reder, S, Schachoff, S, Bschorner, M, Laitinen, I, Robinson, S, Yousefi, B, Schwaiger, M, Kero, Tanja, Lindsjo, L, Antoni, Gunnar, Westermark, P, Carlson, K, Wikstrom, G, Sörensen, Jens, Lubberink, Mark, Rouzet, F, Cognet, T, Guedj, K, Morvan, M, El Shoukr, F, Louedec, L, Choqueux, C, Nicoletti, A, Le Guludec, D, Jimenez-Heffernan, A, Munoz-Beamud, F, Sanchez De Mora, E, Borrachero, C, Salgado, C, Ramos-Font, C, Lopez-Martin, J, Hidalgo, M L, Lopez-Aguilar, R, Soriano, E, Okizaki, A, Nakayama, M, Ishitoya, S, Sato, J, Takahashi, K, Burchert, I, Caobelli, F, Wollenweber, T, Nierada, M, Fulsche, J, Dieckmann, C, Bengel, F M, Shuaib, S, Mahlum, D, Port, S, Refoyo, E, Cuesta, E, Guzman, G, Lopez, T, Valbuena, S, Del Prado, S, Moreno, M, Harbinson, M, Donnelly, L, Einstein, A J, Johnson, L L, Deluca, A J, Kontak, A C, Groves, D W, Stant, J, Pozniakoff, T, Cheng, B, Rabbani, L E, Bokhari, S, Schuetze, C, Aguade-Bruix, S, Pizzi, M N, Romero-Farina, G, Terricabras, M, Villasboas, D, Castell-Conesa, J, Candell-Riera, J, Brunner, S, Gross, L, Todica, A, Lehner, S, Di Palo, A, Niccoli Asabella, A, Magarelli, C, Notaristefano, A, Ferrari, C, Rubini, G, Sellem, A, Melki, S, Elajmi, W, Hammami, H, Ziadi, M C, Montero, J, Ameriso, J L, Villavicencio, R L, Benito Gonzalez, T F, Mayorga Bajo, A, Gutierrez Caro, R, Rodriguez Santamarta, M, Alvarez Roy, L, Martinez Paz, E, Barinaga Martin, C, Martin Fernandez, J, Alonso Rodriguez, D, Iglesias Garriz, I, Rosillo, S, Taleb, S, Cherkaoui Salhi, G, Regbaoui, Y, Ait Idir, M, Guensi, A, Martin Lopez, C E, Castano Ruiz, M, Bouyoucef, S E, Uusitalo, V, Kamperidis, V, De Graaf, M A, Maaniitty, T, Stenstrom, I, Broersen, A, Scholte, A J, Saraste, A, Bax, J J, Knuuti, J, Furuhashi, T, Moroi, M, Awaya, T, Masai, H, Minakawa, M, Kunimasa, T, Fukuda, H, Sugi, K, Berezin, A, Kremzer, A, Clerc, O F, Kaufmann, B, Possner, M, Liga, R, Vontobel, J, Mikulicic, F, Graeni, C, Benz, D C, Kaufmann, P A, Buechel, R B, Ferreira, Mjv, Cunha, M J, Albuquerque, A, Ramos, D, Costa, G, Lima, J, Pego, M, Peix, A, Cisneros, L, Cabrera, L O, Padron, K, Rodriguez, L, Heres, F, Carrillo, R, Mena, E, Fernandez, Y, Huizing, E D, Van Dijk, J D, Van Dalen, J A, Timmer, J R, Ottervanger, J P, Slump, C H, Jager, P L, Venuraju, S, Jeevarethinam, A, Yerramasu, A, Atwal, S, Mehta, V S, Lahiri, A, Arjonilla Lopez, A, Calero Rueda, M J, Gallardo, G, Fernandez-Cuadrado, J, Hernandez Aceituno, D, Sanchez Hernandez, J, Yoshida, H, Mizukami, A, Matsumura, A, Smettei, O, Abazid, R, Sayed, S, Mlynarska, A, Mlynarski, R, Golba, K, Sosnowski, M, Winther, S, Svensson, M, Jorgensen, H S, Bouchelouche, K, Gormsen, L C, Holm, N R, Botker, H E, Ivarsen, P R, Bottcher, M, Cortes, C M, Aramayo G, E N, Daicz, M, Casuscelli, J F, Alaguibe, E D, Neira Sepulveda, A, Cerda, M, Ganum, G E, Embon, M, Vigne, J, Enilorac, B, Lebasnier, A, Valancogne, L, Peyronnet, D, Manrique, A, Agostini, D, Menendez, D, Rajpal, S, Kocherla, C, Acharya, M, Reddy, P, Sazonova, I, Ilushenkova, Yun, Batalov, R E, Rogovskaya, Y V, Lishmanov, Y B, Popov, S V, Varlamova, N V, Prado Diaz, S, Jimenez Rubio, C, Gemma, D, Refoyo Salicio, E, Valbuena Lopez, S C, Moreno Yanguela, M, Torres, M, Fernandez-Velilla, M, Lopez-Sendon, J L, Guzman Martinez, G, Puente, A, Rosales, S, Martinez, C, Cabada, M, Melendez, G M, Ferreira, R, Gonzaga, A, Santos, J, Vijayan, S, Smith, Smg, Smith, M, Muthusamy, R, Takeishi, Y, Oikawa, M, Goral, J L, Napoli, J, Montana, O R, Damico, A C, Quiroz, M C, Damico, A E, Forcada, P J, Schmidberg, J M, Zucchiatti, N E, Olivieri, D B, Dumo, A, Ruano, S, Rakhit, R, Davar, J, Nair, D, Cohen, M, Darko, D, Yokota, S, Maas, Ahe, Mouden, M, Knollema, S, Sanja Mazic, S M, Lazovic, B, Marina Djelic, Mdj, Jelena Suzic Lazic, J S, Tijana Acimovic, T A, Milica Deleva, M D, Vesnina, Z H, Zafrir, N, Bental, T, Mats, I, Solodky, A, Gutstein, A, Hasid, Y, Belzer, D, Kornowski, R, Ben Said, Rim, Ben Mansour, N, Ibn Haj Amor, H, Chourabi, C, Hagui, A, Fehri, W, Hawala, H, Shugushev, Z, Patrikeev, A, Maximkin, D, Chepurnoy, A, Kallianpur, V, Mambetov, A, Dokshokov, G, Teresinska, A, Wozniak, O, Maciag, A, Wnuk, J, Dabrowski, A, Czerwiec, A, Jezierski, J, Biernacka, K, Robinson, J, Prosser, J, Cheung, Gsm, Allan, S, Mcmaster, G, Reid, S, Tarbuck, A, Martin, W, Queiroz, R C, Falcao, A, Giorgi, McP, Imada, R, Nogueira, S A, Chalela, W A, Kalil Filho, R, Meneghetti, W A, Matveev, V V, Bubyenov, A S, Podzolkov, V I, Baranovich, V, Faibushevich, A, Kolzhecova, Y, Volkova, O, Fernandez, J, Lopez, G, Dondi, M, Paez, D, Butcher, Cjt, Reyes, E, Al-Housni, M B, Green, R, Santiago, H, Ghiotto, F, Hinton-Taylor, S, Pottle, A, Mason, M, Underwood, S R, Casans Tormo, I, Diaz-Exposito, R, Plancha-Burguera, E, Elsaban, K, Alsakhri, Hijji, Yoshinaga, K, Ochi, N, Tomiyama, Y, Katoh, C, Inoue, M, Nishida, M, Suzuki, E, Manabe, O, Ito, Y M, Tamaki, N, Tahilyani, A, Jafary, Fahim, Ho Hee Hwa, H H, Ozdemir, S, Kirilmaz, B, Barutcu, A, Tan, Y Z, Celik, F, Sakgoz, S, Cabada Gamboa, M, Puente Barragan, A, Morales Vitorino, N, Medina Servin, M A, Hindorf, C, Akil, S, Hedeer, F, Jogi, J, Engblom, H, Martire, V D, Pis Diez, E R, Martire, M V, Portillo, D O, Hoff, C M, Balche, A, Majgaard, J, Tolbod, L P, Harms, H J, Soerensen, J, Froekiaer, J, Nudi, F, Neri, G, Procaccini, E, Pinto, A, Vetere, M, Biondi-Zoccai, G, Soares, J, Do Val, R, Oliveira, M A, Meneghetti, J C, Tekabe, Y, Anthony, T, Li, Q, Schmidt, A M, Johnson, L, Groenman, M, Tarkia, M, Kakela, M, Halonen, P, Kiviniemi, T, Pietila, M, Yla-Herttuala, S, Roivainen, A, Nekolla, S, Swirzek, S, Higuchi, T, Reder, S, Schachoff, S, Bschorner, M, Laitinen, I, Robinson, S, Yousefi, B, Schwaiger, M, Kero, Tanja, Lindsjo, L, Antoni, Gunnar, Westermark, P, Carlson, K, Wikstrom, G, Sörensen, Jens, Lubberink, Mark, Rouzet, F, Cognet, T, Guedj, K, Morvan, M, El Shoukr, F, Louedec, L, Choqueux, C, Nicoletti, A, Le Guludec, D, Jimenez-Heffernan, A, Munoz-Beamud, F, Sanchez De Mora, E, Borrachero, C, Salgado, C, Ramos-Font, C, Lopez-Martin, J, Hidalgo, M L, Lopez-Aguilar, R, Soriano, E, Okizaki, A, Nakayama, M, Ishitoya, S, Sato, J, Takahashi, K, Burchert, I, Caobelli, F, Wollenweber, T, Nierada, M, Fulsche, J, Dieckmann, C, Bengel, F M, Shuaib, S, Mahlum, D, Port, S, Refoyo, E, Cuesta, E, Guzman, G, Lopez, T, Valbuena, S, Del Prado, S, Moreno, M, Harbinson, M, Donnelly, L, Einstein, A J, Johnson, L L, Deluca, A J, Kontak, A C, Groves, D W, Stant, J, Pozniakoff, T, Cheng, B, Rabbani, L E, Bokhari, S, Schuetze, C, Aguade-Bruix, S, Pizzi, M N, Romero-Farina, G, Terricabras, M, Villasboas, D, Castell-Conesa, J, Candell-Riera, J, Brunner, S, Gross, L, Todica, A, Lehner, S, Di Palo, A, Niccoli Asabella, A, Magarelli, C, Notaristefano, A, Ferrari, C, Rubini, G, Sellem, A, Melki, S, Elajmi, W, Hammami, H, Ziadi, M C, Montero, J, Ameriso, J L, Villavicencio, R L, Benito Gonzalez, T F, Mayorga Bajo, A, Gutierrez Caro, R, Rodriguez Santamarta, M, Alvarez Roy, L, Martinez Paz, E, Barinaga Martin, C, Martin Fernandez, J, Alonso Rodriguez, D, Iglesias Garriz, I, Rosillo, S, Taleb, S, Cherkaoui Salhi, G, Regbaoui, Y, Ait Idir, M, Guensi, A, Martin Lopez, C E, and Castano Ruiz, M

Published
2015
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18. Glucose dysregulation in nondiabetic patients with ST-elevation myocardial infarction: acute and chronic glucose dysregulation in STEMI

Author

Rasoul, S., Ottervanger, J. P., Bilo, H. J. G., Timmer, J. R., van't Hof, A. W. J., Dikkeschei, L. D., Hoorntje, J. C. A., de Boer, M. J., Zijlstra, F., Dambrink, Jan Hendrik Everwijn, Faculteit Medische Wetenschappen/UMCG, and Lifestyle Medicine (LM)

Subjects
RISK, MORTALITY, BLOOD-GLUCOSE, DIABETES-MELLITUS, HbAic, METABOLISM, ISCHEMIC-MYOCARDIUM, THROMBOLYTIC ERA, ST-elevation acute myocardial infarction, CARDIOVASCULAR-DISEASE, outcome, STRESS HYPERGLYCEMIA, FATTY-ACIDS, admission glucose
Abstract

Background: Admission hyperglycaemia is associated with an increased risk of mortality after myocardial infarction. Whether long-term glucose dysregulation (assessed by HbAic) is more important than acute hyperglycaemia is unknown. We evaluated the prognostic value of admission glucose and HbAic levels in nondiabetic patients with ST-segment elevation acute myocardial infarction (STEMI). Methods: In 504 unselected, consecutive patients with STEMI, glucose and HbAic levels were measured on admission. Glucose was categorised as = 11.1 mmol/l (n=82). HbAic levels were categorised as = 6.0% (n=88). Mean follow-up was 1.6 +/- 0.6 years. Results: Patients with hyperglycaemia on admission were comparable with those with normoglycaernia. However, patients with HbAic >= 6.0%, as compared with those with HbAic = 11.1 mmol/l) was 4% and 19% (p= 6%) was 5% and 12% (p=0.03)After multivariable analyses, admission glucose (OR 4.91, 95% CI 2.03 to 11.9, p

Published
2007

19. Long-term clinical outcome of patients with diabetes proposed for coronary revascularisation

Author

Timmer, J. R., Breeman, A., Ottervanger, J. P., de Kluiver, E. P., Boonstra, P. W., and Zijlstra, F.

Subjects
ACUTE MYOCARDIAL-INFARCTION, ARTERY-BYPASS SURGERY, MELLITUS, EMORY ANGIOPLASTY, diabetes, INVESTIGATION BARI, ABNORMALITIES, MORTALITY, revascularisation, SURVIVAL, TRIAL, CABG, DISEASE
Abstract

Background: The optimal method of revascularisation in diabetic patients with coronary artery disease (CAD) remains controversial. It was our aim to evaluate long-term outcome in diabetic patients with CAD in daily practice, in whom an invasive approach was considered. Methods: A prospective follow-up study of patients with CAD in whom a coronary revascularisation procedure was considered. Follow-up data were obtained on the vital status up to ten years after inclusion. Results: Of the 872 included patients, a total Of 107 patients (12%) had diabetes. Patients with diabetes were older and more frequently female. Long-term mortality was higher in diabetics than nondiabetics (36 vs 25%, p = 0.01). This association was observed in both medically treated patients (65 vs 31%, p = 0.01) and in those treated by percutaneous coronary intervention (41 vs 24%, p = 0.02). There was, however, no difference in mortality in diabetes vs nondiabetes patients after coronary artery bypass grafting (24 vs 24%, p = 0.89). Multivariate analysis did not change these findings. Conclusion: Diabetic patients with significant CAD had a higher long-term mortality compared with patients without diabetes. In patients with diabetes, survival was highest after coronary artery bypass grafting and appeared to be comparable between diabetic and nondiabetic patients. Complete revascularisation may decrease the influence of diabetes on survival.

Published
2006

22. Abstracts

Author

Dunet, V., primary, Dabiri, A., additional, Allenbach, G., additional, Goyeneche Achigar, A., additional, Waeber, B., additional, Feihl, F., additional, Heinzer, R., additional, Prior, J. O., additional, Van Velzen, J. E., additional, Schuijf, J. D., additional, De Graaf, F. R., additional, De Graaf, M. A., additional, Schalij, M. J., additional, Kroft, L. J., additional, De Roos, A., additional, Jukema, J. W., additional, Van Der Wall, E. E., additional, Bax, J. J., additional, Lankinen, E., additional, Saraste, A., additional, Noponen, T., additional, Klen, R., additional, Teras, M., additional, Kokki, T., additional, Kajander, S., additional, Pietila, M., additional, Ukkonen, H., additional, Knuuti, J., additional, Pazhenkottil, A. P., additional, Nkoulou, R. N., additional, Ghadri, J. R., additional, Herzog, B. A., additional, Buechel, R. R., additional, Kuest, S. M., additional, Wolfrum, M., additional, Gaemperli, O., additional, Husmann, L., additional, Kaufmann, P. A., additional, Andreini, D., additional, Pontone, G., additional, Mushtaq, S., additional, Antonioli, L., additional, Bertella, E., additional, Formenti, A., additional, Cortinovis, S., additional, Ballerini, G., additional, Fiorentini, C., additional, Pepi, M., additional, Koh, A. S., additional, Flores, J. S., additional, Keng, F. Y. J., additional, Tan, R. S., additional, Chua, T. S. J., additional, Annoni, A. D., additional, Tamborini, G., additional, Fusari, M., additional, Bartorelli, A. L., additional, Ewe, S. H., additional, Ng, A. C. T., additional, Delgado, V., additional, Schuijf, J., additional, Van Der Kley, F., additional, Colli, A., additional, De Weger, A., additional, Marsan, N. A., additional, Yiu, K. H., additional, Ng, A. C., additional, Timmer, S. A. J., additional, Knaapen, P., additional, Germans, T., additional, Dijkmans, P. A., additional, Lubberink, M., additional, Ten Berg, J. M., additional, Ten Cate, F. J., additional, Russel, I. K., additional, Lammertsma, A. A., additional, Van Rossum, A. C., additional, Wong, Y. Y., additional, Ruiter, G., additional, Raijmakers, P., additional, Van Der Laarse, W. J., additional, Westerhof, N., additional, Vonk-Noordegraaf, A., additional, Youssef, G., additional, Leung, E., additional, Wisenberg, G., additional, Marriot, C., additional, Williams, K., additional, Etele, J., additional, Dekemp, R. A., additional, Dasilva, J., additional, Birnie, D., additional, Beanlands, R. S. B., additional, Thompson, R. C., additional, Allam, A. H., additional, Wann, L. S., additional, Nureldin, A. H., additional, Adelmaksoub, G., additional, Badr, I., additional, Sutherland, M. L., additional, Sutherland, J. D., additional, Miyamoto, M. I., additional, Thomas, G. S., additional, Harms, H. J., additional, De Haan, S., additional, Huisman, M. C., additional, Schuit, R. C., additional, Windhorst, A. D., additional, Allaart, C., additional, Einstein, A. J., additional, Khawaja, T., additional, Greer, C., additional, Chokshi, A., additional, Jones, M., additional, Schaefle, K., additional, Bhatia, K., additional, Shimbo, D., additional, Schulze, P. C., additional, Srivastava, A., additional, Chettiar, R., additional, Moody, J., additional, Weyman, C., additional, Natale, D., additional, Bruni, W., additional, Liu, Y., additional, Ficaro, E., additional, Sinusas, A. J., additional, Peix, A., additional, Batista, E., additional, Cabrera, L. O., additional, Padron, K., additional, Rodriguez, L., additional, Sainz, B., additional, Mendoza, V., additional, Carrillo, R., additional, Fernandez, Y., additional, Mena, E., additional, Naum, A., additional, Bach-Gansmo, T., additional, Kleven-Madsen, N., additional, Biermann, M., additional, Johnsen, B., additional, Aase Husby, J., additional, Rotevatn, S., additional, Nordrehaug, J. E., additional, Schaap, J., additional, Kauling, R. M., additional, Post, M. C., additional, Rensing, B. J. W. 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W., additional, Verdes, L., additional, Campos, L., additional, Gulyaev, V., additional, Pankova, A., additional, Santos, J., additional, Carmona, S., additional, Henriksson, I., additional, Prata, A., additional, Carrageta, M., additional, Santos, A. I., additional, Yoshinaga, K., additional, Naya, M., additional, Katoh, C., additional, Manabe, O., additional, Yamada, S., additional, Iwano, H., additional, Chiba, S., additional, Tsutsui, H., additional, Tamaki, N., additional, Vassiliadis, I., additional, Despotopoulos, E., additional, Kaitozis, O., additional, Hatzistamatiou, E., additional, Thompson, R., additional, Hatch, J., additional, Zink, M., additional, Gu, B. S., additional, Bae, G. D., additional, Dae, C. M., additional, Min, G. H., additional, Chun, E. J., additional, Choi, S. I., additional, Al-Mallah, M., additional, Kassem, K., additional, Khawaja, O., additional, Goodman, D., additional, Lipkin, D., additional, Christiaens, L., additional, Bonnet, B., additional, Mergy, J., additional, Coisne, D., additional, Allal, J., additional, Dias Ferreira, N., additional, Leite, D., additional, Rocha, J., additional, Carvalho, M., additional, Caeiro, D., additional, Bettencourt, N., additional, Braga, P., additional, Gama Ribeiro, V., additional, Kristoffersen, U. S., additional, Lebech, A. M., additional, Gutte, H., additional, Ripa, R. S., additional, Wiinberg, N., additional, Petersen, C. L., additional, Jensen, G., additional, Kjaer, A., additional, Bai, C., additional, Conwell, R., additional, Folks, R. D., additional, Verdes-Moreiras, L., additional, Manatunga, D., additional, Jacobson, A. F., additional, Belzer, D., additional, Hasid, Y., additional, Rehling, M., additional, Poulsen, R. H., additional, Falborg, L., additional, Rasmussen, J. T., additional, Waehrens, L. N., additional, Heegaard, C. W., additional, Silvola, J. M. U., additional, Forsback, S., additional, Laine, J. O., additional, Heinonen, S., additional, Ylaherttuala, S., additional, Broisat, A., additional, Ruiz, M., additional, Goodman, N. C., additional, Dimastromatteo, J., additional, Glover, D. K., additional, Hyafil, F., additional, Blackwell, F., additional, Pavon-Djavid, G., additional, Sarda-Mantel, L., additional, Feldman, L. J., additional, Meddahi-Pelle, A., additional, Tsatkin, V., additional, Liu, Y.- H., additional, De Kemp, R., additional, Slomka, P. J., additional, Klein, R., additional, Germano, G., additional, Beanlands, R. S., additional, Rohani, A., additional, Akbari, V., additional, Groothuis, J. G. J., additional, Fransen, M., additional, Beek, A. M., additional, Brinckman, S. L., additional, Meijerink, M. R., additional, Hofman, M. B. M., additional, Van Kuijk, C., additional, Kogure, S., additional, Yamashita, E., additional, Murakami, J., additional, Kawaguchi, R., additional, Adachi, H., additional, Oshima, S., additional, Minin, S., additional, Popov, S., additional, Saushkina, Y. U., additional, Savenkova, G., additional, Lebedev, D., additional, Alexandridis, E., additional, Rovithis, D., additional, Parisis, C., additional, Sazonova, I., additional, Saushkin, V., additional, Chernov, V., additional, Zaabar, L., additional, Bahri, H., additional, Hadj Ali, S., additional, Sellem, A., additional, Slim, I., additional, El Kadri, N., additional, Slimen, H., additional, Hammami, H., additional, Lucic, S., additional, Peter, A., additional, Tadic, S., additional, Nikoletic, K., additional, Jung, R., additional, Lucic, M., additional, Tagil, K., additional, Jakobsson, D., additional, Svensson, S.- E., additional, Wollmer, P., additional, Leccisotti, L., additional, Indovina, L., additional, Paraggio, L., additional, Calcagni, M. L., additional, Giordano, A., additional, Kapitan, M., additional, Paolino, A., additional, Nunez, M., additional, Sweeny, J., additional, Kulkarni, N., additional, Guma, K., additional, Akashi, Y., additional, Takano, M., additional, Takai, M., additional, Koh, S., additional, Miyake, F., additional, Torun, N., additional, Durmus Altun, G., additional, Altun, A., additional, Kaya, E., additional, Saglam, H., additional, Matsuoka, D. T., additional, Sanchez, A., additional, Bartolozzi, C., additional, Padua, D., additional, Ponta, G., additional, Ponte, A., additional, Carneiro, A., additional, Thom, A., additional, Ashrafi, R., additional, Garg, P., additional, Davis, G., additional, Falcao, A., additional, Costa, M., additional, Bussolini, F., additional, Meneghetti, J. A. C., additional, Tobisaka, M., additional, Correia, E., additional, Jansen, J. W., additional, Van Der Vleuten, P. A., additional, Willems, T. P., additional, Zijlstra, F., additional, Sato, M., additional, Taniguchi, K., additional, Kurabayashi, M., additional, Pop Gjorcheva, D., additional, Zdraveska-Kochovska, M., additional, Moriwaki, K., additional, Kawamura, A., additional, Watanabe, K., additional, Omura, T., additional, Sakabe, S., additional, Seko, T., additional, Kasai, A., additional, Ito, M., additional, Obana, M., additional, Akasaka, T., additional, Hruska, C., additional, Truong, D., additional, Pletta, C., additional, Collins, D., additional, Tortorelli, C., additional, Rhodes, D., additional, El-Prince, M., additional, Martinez-Moeller, A., additional, Marinelli, M., additional, Weismueller, S., additional, Hillerer, C., additional, Jensen, B., additional, Nekolla, S. G., additional, Wakabayashi, H., additional, Tsukamoto, K., additional, Baker, S. M. E. A., additional, Sirajul Haque, K. M. H. S., additional, Siddique, A., additional, Krishna Banarjee, S., additional, Ahsan, A., additional, Rahman, F., additional, Mukhlesur Rahman, M., additional, Parveen, T., additional, Lutfinnessa, M., additional, Nasreen, F., additional, Sano, H., additional, Naito, S., additional, De Rimini, M. L., additional, Borrelli, G., additional, Baldascino, F., additional, Calabro, P., additional, Maiello, C., additional, Russo, A., additional, Amarelli, C., additional, Muto, P., additional, Danad, I., additional, Raijmakers, P. G., additional, Appelman, Y. E., additional, Hoekstra, O. S., additional, Marcus, J. T., additional, Boonstra, A., additional, Ryzhkova, D. V., additional, Kuzmina, T. V., additional, Borodina, O. S., additional, Trukshina, M. A., additional, Kostina, I. S., additional, Hommel, H., additional, Feuchtner, G., additional, Pachinger, O., additional, Friedrich, G., additional, Stel, A. M., additional, Deckers, J. W., additional, Gama, V., additional, Ciarka, A., additional, Neefjes, L. A., additional, Mollet, N. R., additional, Sijbrands, E. J., additional, Wilczek, J., additional, Llibre Pallares, C., additional, Abdul-Jawad Altisent, O., additional, Cuellar Calabria, H., additional, Mahia Casado, P., additional, Gonzalez-Alujas, M. T., additional, Evangelista Masip, A., additional, Garcia-Dorado Garcia, D., additional, Tekabe, Y., additional, Shen, X., additional, Li, Q., additional, Luma, J., additional, Weisenberger, D., additional, Schmidt, A. M., additional, Haubner, R., additional, Johnson, L., additional, Sleiman, L., additional, Thorn, S., additional, Hasu, M., additional, Thabet, M., additional, Dasilva, J. N., additional, Whitman, S. C., additional, Genovesi, D., additional, Giorgetti, A., additional, Gimelli, A., additional, Cannizzaro, G., additional, Bertagna, F., additional, Fagioli, G., additional, Rossi, M., additional, Bonini, R., additional, Marzullo, P., additional, Paterson, C. A., additional, Smith, S. A., additional, Small, A. D., additional, Goodfield, N. E. R., additional, Martin, W., additional, Nekolla, S., additional, Sherif, H., additional, Reder, S., additional, Yu, M., additional, Kusch, A., additional, Li, D., additional, Zou, J., additional, Lloyd, M. S., additional, Cao, K., additional, Motherwell, D. W., additional, Rice, A., additional, Mccurrach, G. M., additional, Cobbe, S. M., additional, Petrie, M. C., additional, Al Younis, I., additional, Van Der Wall, E., additional, Mirza, T., additional, Raza, M., additional, Hashemizadeh, H., additional, Santos, L., additional, Krishna, B. A., additional, Perna, F., additional, Lago, M., additional, Leo, M., additional, Pelargonio, G., additional, Bencardino, G., additional, Narducci, M. L., additional, Casella, M., additional, Bellocci, F., additional, Kirac, S., additional, Yaylali, O., additional, Serteser, M., additional, Yaylali, T., additional, Okizaki, A., additional, Urano, Y., additional, Nakayama, M., additional, Ishitoya, S., additional, Sato, J., additional, Ishikawa, Y., additional, Sakaguchi, M., additional, Nakagami, N., additional, Aburano, T., additional, Solav, S. V., additional, Bhandari, R., additional, Burrell, S., additional, Dorbala, S., additional, Bruno, I., additional, Caldarella, C., additional, Collarino, A., additional, Mattoli, M. V., additional, Stefanelli, A., additional, Cannarile, A., additional, Maggi, F., additional, Soukhov, V., additional, Bondarev, S., additional, Yalfimov, A., additional, Khan, M., additional, Priyadharshan, P. P., additional, Chandok, G., additional, Aziz, T., additional, Avison, M., additional, Smith, R. A., additional, Bulugahapitya, D. S., additional, Vakhtangadze, T., additional, Todua, F., additional, Baramia, M., additional, Antelava, G., additional, Roche, N.- C., additional, Paule, P., additional, Kerebel, S., additional, Gil, J.- M., additional, Fourcade, L., additional, Tzonevska, A., additional, Tzvetkov, K., additional, Atanasova, M., additional, Parvanova, V., additional, Chakarova, A., additional, Piperkova, E., additional, Kocabas, B., additional, Muderrisoglu, H., additional, Allaart, C. P., additional, Entok, E., additional, Simsek, S., additional, Akcay, B., additional, Ak, I., additional, Vardareli, E., additional, Stachura, M., additional, Kwasiborski, P. J., additional, Horszczaruk, G. J., additional, Komar, E., additional, Cwetsch, A., additional, Zraik, B., additional, Morales Demori, R., additional, Almeida, A. D. J., additional, Siqueira, M. E., additional, Vieira, E., additional, Balogh, I., additional, Kerecsen, G., additional, Marosi, E., additional, Szelid, Z. S., additional, Sattar, A., additional, Swadia, T., additional, Chattahi, J., additional, Qureshi, W., additional, Khalid, F., additional, Gonzalez, A., additional, Hechavarria, S., additional, Takamura, K., additional, Fujimoto, S., additional, Nakanishi, R., additional, Yamashina, S., additional, Namiki, A., additional, Yamazaki, J., additional, Koshino, K., additional, Hashikawa, Y., additional, Teramoto, N., additional, Hikake, M., additional, Ishikane, S., additional, Ikeda, T., additional, Iida, H., additional, Takahashi, Y., additional, Oriuchi, N., additional, Higashino, H., additional, Endo, K., additional, Mochizuki, T., additional, Murase, K., additional, Baali, A., additional, Moreno, R., additional, Chau, M., additional, Rousseau, H., additional, Nicoud, F., additional, Dolliner, P., additional, Brammen, L., additional, Steurer, G., additional, Traub-Weidinger, T., additional, Ubl, P., additional, Schaffarich, P., additional, Dobrozemsky, G., additional, Staudenherz, A., additional, Ozgen Kiratli, M., additional, Temelli, B., additional, Kanat, N. B., additional, Aksoy, T., additional, Slavich, G. A., additional, Piccoli, G., additional, Puppato, M., additional, Grillone, S., additional, Gasparini, D., additional, Dunet, V., additional, Perruchoud, S., additional, Poitry-Yamate, C., additional, Lepore, M., additional, Gruetter, R., additional, Pedrazzini, T., additional, Anselm, D., additional, Anselm, A., additional, Atkins, H., additional, Renaud, J., additional, Dekemp, R., additional, Burwash, I., additional, Guo, A., additional, Beanlands, R., additional, Glover, C., additional, Vilardi, I., additional, Zangheri, B., additional, Calabrese, L., additional, Romano, P., additional, Bruno, A., additional, Fernandez Cimadevilla, O. C., additional, Uusitalo, V. A., additional, Luotolahti, M., additional, Wendelin-Saarenhovi, M., additional, Sundell, J., additional, Raitakari, O., additional, Huidu, S., additional, Gadiraju, R., additional, Ghesani, M., additional, Uddin, Q., additional, Wosnitzer, B., additional, Takahashi, N., additional, Alhaj, E., additional, Legasto, A., additional, Abiri, B., additional, Elsaban, K., additional, El Khouly, T., additional, El Kammash, T., additional, Al Ghamdi, A., additional, Kyung Deok, B., additional, Bon Seung, K., additional, Sang Geun, Y., additional, Chang Min, D., additional, and Gwan Hong, M., additional

Published
2011
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24. Visual estimation of coronary calcium on computed tomography for attenuation correction.

Author

Engbers EM, Timmer JR, Mouden M, Jager PL, Knollema S, Oostdijk AH, and Ottervanger JP

Subjects
Aged, Coronary Artery Disease physiopathology, Coronary Circulation, Coronary Vessels physiopathology, Female, Humans, Male, Middle Aged, Observer Variation, Predictive Value of Tests, Prognosis, Reproducibility of Results, Severity of Illness Index, Vascular Calcification physiopathology, Computed Tomography Angiography, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Multidetector Computed Tomography, Myocardial Perfusion Imaging methods, Single Photon Emission Computed Tomography Computed Tomography, Vascular Calcification diagnostic imaging
Abstract

Background: The coronary calcium score (CCS) provides independent diagnostic and prognostic information on top of myocardial perfusion imaging (MPI) in patients suspected for coronary artery disease, but requires an additional computed tomography (CT) scan., Objective: We investigated the accuracy and inter-reader reproducibility of visual estimation of the CCS on the CT used for attenuation correction., Methods: 250 patients undergoing single photon emission computed tomography MPI and Agatston CCS were included. The CCS was also visually estimated on the CT for attenuation correction by two separate readers blinded to the Agatston CCS, and was categorized into a six-point scale (0, 1-10, 11-100, 101-400, 401-1000 and > 1000)., Results: The median Agatston CCS was 82 [25th-75th percentile: 0-562], with a range from 0 to 7287. Of the visually estimated CCS, 60% (reader 1) and 65% (reader 2) were classified correctly into the 6 categories. 93% (reader 1) and 88% (reader 2) of the visually estimated CCS did not vary by more than one category from the Agatston CCS. The intraclass correlation coefficient for agreement between the Agatston CCS and the visually estimated CCS was 0.95 for reader 1 and 0.94 for reader 2. The intraclass correlation coefficient for inter-reader reproducibility of the visually estimated CCS was 0.96., Conclusion: The CCS can be accurately estimated on the CT for attenuation correction, as high agreement is demonstrated with the Agatston CCS and inter-reader reproducibility is excellent. If no traditional Agatston CCS is performed, the degree of atherosclerosis should be assessed by means of estimating CCS on the CT for attenuation correction., (Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Published
2016
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25. Zero coronary calcium in the presence of three-vessel and left main coronary artery disease in a Hodgkin lymphoma survivor.

Author

Engbers EM, Mouden M, Jager PL, and Timmer JR

Abstract

We describe a 45-year-old male survivor of Hodgkin lymphoma, treated with mediastinal radiation therapy, referred for single-photon emission computed tomography (SPECT) myocardial perfusion imaging in combination with coronary artery calcium (CAC) scoring. SPECT demonstrated a reversible moderate-sized lateral perfusion defect, and the CAC score was zero. A calcium score of zero markedly reduces the probability of having coronary artery disease (CAD) and is associated with a very low risk of future cardiovascular events. However, a CAC score of zero does not completely rule out obstructive CAD. In this case, invasive coronary angiography revealed three-vessel CAD with left main involvement. Whether mediastinal radiation therapy in general is associated with CAD without accompanying CAC is yet unclear.

Published
2015
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26. Glucose dysregulation in nondiabetic patients with ST-elevation myocardial infarction: acute and chronic glucose dysregulation in STEMI.

Author

Rasoul S, Ottervanger JP, Bilo HJ, Timmer JR, van 't Hof AW, Dambrink JH, Dikkeschei LD, Hoorntje JC, de Boer MJ, and Zijlstra F

Subjects
Acute Disease, Aged, Biomarkers blood, Chronic Disease, Female, Hospitalization, Humans, Male, Middle Aged, Myocardial Infarction blood, Myocardial Infarction mortality, Prognosis, Prospective Studies, Risk Factors, Time, Blood Glucose analysis, Glycated Hemoglobin analysis, Myocardial Infarction physiopathology, Treatment Outcome
Abstract

Background: Admission hyperglycaemia is associated with an increased risk of mortality after myocardial infarction. Whether long-term glucose dysregulation (assessed by HbA1c) is more important than acute hyperglycaemia is unknown. We evaluated the prognostic value of admission glucose and HbA1c levels in nondiabetic patients with ST-segment elevation acute myocardial infarction (STEMI)., Methods: In 504 unselected, consecutive patients with STEMI, glucose and HbA1c levels were measured on admission. Glucose was categorised as <11.1 mmol/l (n=422) and >or= 11.1 mmol/l (n=82). HbA1c levels were categorised as <6.0% (n=416) and >or=6.0% (n=88). Mean follow-up was 1.6+/-0.6 years., Results: Patients with hyperglycaemia on admission were comparable with those with normoglycaemia. However,patients with HbA1c >or=6.0%, as compared with those with HbA1c <6%, were older, were more often on beta-blockers and more frequently had multivessel disease. Thirty-day mortality in the subsequent glucose categories (<11.1 mmol/l and >or=11.1 mmol/l) was 4% and 19% (p<0.001) and in the subsequent HbA1c categories (<6% and >or=6%) was 5% and 12% (p=0.03). After multivariable analyses, admission glucose (OR 4.91,95% CI 2.03 to 11.9, p< 0.001) but not HbA1c (OR 1.33, 95%CI 0.48 to 3.71, p=0.58) was significantly associated with 30-day mortality. Among 30-day survivors, neither admission glucose nor HbA1c were predictors of long-term mortality., Conclusion: Elevated admission glucose is an important predictor of 30-day outcome after STEMI, while prior long-term glucose dysregulation is a covariate of other high-risk clinical characteristics. Among 30-day survivors, neither admission blood glucose nor HbA1c were predictors of long-term outcome.

Published
2007

27. Long-term clinical outcome of patients with diabetes proposed for coronary revascularisation.

Author

Timmer JR, Breeman A, Ottervanger JP, de Kluiver EP, Boonstra PW, and Zijlstra F

Subjects
Aged, Coronary Disease complications, Coronary Disease mortality, Diabetes Mellitus surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Survival Rate trends, Treatment Outcome, Coronary Disease surgery, Diabetes Mellitus mortality, Myocardial Revascularization methods
Abstract

Background: The optimal method of revascularisation in diabetic patients with coronary artery disease (CAD) remains controversial. It was our aim to evaluate long-term outcome in diabetic patients with CAD in daily practice, in whom an invasive approach was considered., Methods: A prospective follow-up study of patients with CAD in whom a coronary revascularisation procedure was considered. Follow-up data were obtained on the vital status up to ten years after inclusion., Results: Of the 872 included patients, a total of 107 patients (12%) had diabetes. Patients with diabetes were older and more frequently female. Long-term mortality was higher in diabetics than nondiabetics (36 vs 25%, p = 0.01). This association was observed in both medically treated patients (65 vs 31%, p = 0.01) and in those treated by percutaneous coronary intervention (41 vs 24%, p = 0.02). There was, however, no difference in mortality in diabetes vs nondiabetes patients after coronary artery bypass grafting (24 vs 24%, p = 0.89). Multivariate analysis did not change these findings., Conclusion: Diabetic patients with significant CAD had a higher long-term mortality compared with patients without diabetes. In patients with diabetes, survival was highest after coronary artery bypass grafting and appeared to be comparable between diabetic and nondiabetic patients. Complete revascularisation may decrease the influence of diabetes on survival.

Published
2006

28. Prognostic value of admission glucose and glycosylated haemoglobin levels in acute coronary syndromes.

Author

Timmer JR, Ottervanger JP, Bilo HJ, Dambrink JH, Miedema K, Hoorntje JC, and Zijlstra F

Subjects
Aged, Coronary Disease mortality, Epidemiologic Methods, Female, Hospitalization, Humans, Male, Middle Aged, Blood Glucose analysis, Coronary Disease blood, Glycated Hemoglobin analysis
Abstract

Background: Admission hyperglycaemia is associated with poorer prognosis in patients with an acute coronary syndrome (ACS). Whether hyperglycaemia is more important than prior long-term glucose metabolism, is unknown., Aim: To investigate the prognostic value of admission glucose and HbA(1c) levels in patients with ACS., Methods: We measured glucose and HbA(1c) at admission in 521 consecutive patients with suspected ACS. Glucose was categorized as <7.8 (n = 305), 7.8-11.0 (n = 138) or > or =11.1 mmol/l (n = 78); HbA(1c) as <6.2% (n = 420) or > or =6.2% (n = 101). Mean follow-up was 1.6 +/- 0.5 years., Results: The diagnosis of ACS was confirmed in 332 patients (64%), leaving 189 (36%) with atypical chest pain. In ACS patients, mortality by glucose category (<7.8, 7.8-11.0 or > or =11.1 mmol) was 9%, 8% and 25%, respectively (p = 0.001); mortality by HbA(1c) category (<6.2% vs. > or =6.2%) was 10% vs. 17%, respectively (p = 0.14). On multivariate analysis, glucose category was significantly associated with mortality (HR 3.0, 95% CI 1.1-8.3), but HbA(1c) category was not (HR 1.5, 95%CI 0.6-4.2)., Discussion: Elevated admission glucose appears more important than prior long-term abnormal glucose metabolism in predicting mortality in patients with suspected ACS.

Published
2006
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29. Glucose and potassium derangements by glucose-insulin-potassium infusion in acute myocardial infarction.

Author

van der Horst IC, Timmer JR, Ottervanger JP, Bilo HJ, Miedema K, Gans RO, de Boer MJ, Vogelzang M, Nijsten MW, and Zijlstra F

Abstract

Background: High-dose glucose-insulin-potassium infusion (GIK) has been suggested to be beneficial in acute myocardial infarction (MI). Recently new large trials have shown no effect of GIK on mortality. To investigate whether metabolic derangement could have negated the potential beneficial effect, we studied the relation between systemic glucose and potassium levels and outcome., Methods: Patients with signs and symptoms of ST-segment-elevation MI and treated with primary percutaneous coronary intervention (PCI) were randomised to no infusion or high-dose GIK, i.e. 80 mmol potassium chloride in 500 ml 20% glucose at a rate of 3 ml/kg/hour and 50 units short-acting insulin in 50 ml 0.9% sodium chloride for 12 hours., Results: A total of 6991 glucose values and 7198 potassium values were obtained in 476 GIK patients and 464 controls. Mean serum glucose was significantly higher in the GIK group (9.3±4.5 mmol/l vs. 8.4±2.9 mmol/l, p<0.001). Mean potassium level was significantly higher in the GIK group (4.2±0.5 mmol/l vs. 3.9±0.4 mmol/l, p<0.001). Incidence of hyperglycaemia (glucose >11.0 mmol/l) occurred in 70.8% of GIK patients and 33.8% of controls (p<0.001). Hypokalaemia was less common in the GIK group (23.5 vs. 41.2%, p<0.001). Incidence of hyperkalaemia and hypoglycaemia did not differ significantly between the two groups. In multivariate analysis age, previous cardiovascular disease, Killip class >1, unsuccessful PCI and mean glucose after admission were associated with increased one-year mortality., Conclusion: In ST-segment-elevation MI patients treated with primary PCI, high-dose GIK induced hyperglycaemia and prevented hypokalaemia. Derangement of the glucose metabolism was related to one-year mortality.

Published
2006

30. A quantitative analysis of the effect of glucose-insulin-potassium in acute myocardial infarction.

Author

Rasoul S, Svilaas T, Ottervanger JP, Timmer JR, van 't Hof AW, and Zijlstra F

Abstract

Objective: To review the currently available data to investigate the clinical benefit of high- and low-dose glucose-insulin-potassium (GIK) in patients with ST-segment elevation acute myocardial infarction (STEMI)., Design: Quantitative analysis of all randomised trials on GIK in patients with STEMI. Electronic and manual searches for randomised controlled trials of GIK in STEMI were performed with regard to inclusion criteria, dose of GIK and additional use of reperfusion therapy, and a meta-analysis with the primary endpoint 30-day mortality was performed., Patients: Data from 16 randomised trials, involving 26,273 patients, were included., Results: Studies were conducted between 1962 and 2005. Overall, hospital mortality was 9.6% after GIK compared with 10.2% in controls (p=0.088). GIK infusion was not associated with an increase in major adverse events., Conclusion: This quantitative analysis of GIK in patients with STEMI did not show a beneficial or detrimental effect of GIK infusion on 30-day mortality. GIK infusion should not be part of the standard therapy for patients with STEMI.

Published
2006

32. Dysglycemia in suspected acute coronary syndromes.

Author

Timmer JR, Bilo HJ, Ottervanger JP, Dambrink JH, Miedema K, Hoorntje JC, and Zijlstra F

Abstract

BACKGROUND: Apart from diabetes itself, even minor glycometabolic dysregulation may be associated with an increased risk of cardiovascular disease. We analyzed the prevalence and predictive value of glycometabolic disturbances in patients with a suspected acute coronary syndrome (ACS). METHODS: In a prospective follow-up study, admission glucose and Hba1C levels in all consecutive patients with suspected ACS were measured. Dysglycemia was defined as a Hba1C of 5.6-6.1% with a non-fasting glucose above 7.8 mmol/L. Both predictors of glycometabolic disturbances and the predictive value of glycometabolic disturbances were studied. RESULTS: Of the 521 patients with a suspected ACS who were included in the study, 332 (64%) had an ACS and 189 (36%) had atypical chest pain. A total of 115 patients (22%) had diabetes and 65 (13%) had dysglycemia. Patients with diabetes or dysglycemia had an increased risk of a confirmed diagnosis of ACS (RR 2.3, 95% CI 1.5-3.4). Multivariate analyses did not change these findings. CONCLUSIONS: One in three patients with suspected ACS had a glucose metabolism disturbance. Glycometabolic disturbance was strongly associated with a confirmed diagnosis of ACS. Whether intensive treatment of patients with disturbed glucose metabolism may improve long-term prognosis needs to be assessed.

Published
2005
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33. Long-term clinical outcome of ST-segment elevation myocardial infarction patients with and without diabetes mellitus in the Zwolle trial.

Author

Timmer JR, van der Horst IC, Henriques JP, Thomas K, Bilo HJ, Hoorntje JC, de Boer MJ, Suryapranata H, and Zijlstra F

Abstract

Objectives: We sought to compare long-term survival after ST-segment elevation myocardial infarction (STEMI) in patients with and without diabetes mellitus (DM) treated with primary percutaneous coronary intervention (PCI) or thrombolytic therapy., Background: DM is an adverse prognostic factor after STEMI. However, there is only limited information about long-term clinical outcome in STEMI patients with DM treated with PCI or thrombolysis., Methods: Patients with STEMI (n=395) were randomised to treatment either with intravenous streptokinase or PCI. Mean follow-up was 8±2 years. We studied long-term mortality of patients with DM (n=32) and without DM (n=363) and the interaction with the treatment regimen., Results: After eight years, a total of 17 patients with DM (53%) died compared with 88 (24%) patients without DM (OR 3.5, p<0.001). Reduced left ventricular ejection fraction (LVEF) after STEMI was more often present in patients with DM compared with patients without DM (31% vs. 15%, p=0.01). Multivariate analysis revealed that DM (OR 2.6, 95% CI 1.4-4.7, p=0.002), reduced LVEF (OR 2.4, 95% CI 1.5-3.8, p<0.001) and age ≥60 years (OR 2.4, 95% CI 1.5-3.8, p<0.001) were independent risk factors for long-term mortality. Patients with DM treated with PCI had less LVEF (13% vs. 53%, p=0.01) and lower long-term mortality rates (38% vs. 69%, p=0.08) compared with treatment with thrombolysis., Conclusions: STEMI patients with DM are a high-risk group with higher long-term mortality rates compared with patients without DM. PCI is the treatment of choice, particularly in DM patients.

Published
2003

34. No long-lasting or intermittent mast cell activation in acute coronary syndromes.

Author

van Haelst PL, Timmer JR, Crijns HJ, Kauffman HF, Gans RO, and van Doormaal JJ

Subjects
Adult, Aged, Angina, Unstable blood, C-Reactive Protein analysis, Female, Humans, Male, Middle Aged, Myocardial Infarction blood, Pilot Projects, Serine Endopeptidases blood, Tryptases, Angina, Unstable physiopathology, Mast Cells physiology, Myocardial Infarction physiopathology
Abstract

Background: Unstable coronary syndromes, such as acute myocardial infarction and unstable angina pectoris are mostly due to rupture of an atherosclerotic plaque. Recently mast cells were found to participate actively in the inflammatory process of atherosclerosis by excreting proteolytic and pro-inflammatory substances with the ability to cause plaque instability and rupture. Mast cell activity can be determined by measuring serum levels of tryptase, as has been demonstrated in patients with anaphylaxis and mastcytosis., Hypothesis: Acute coronary events (acute myocardial infarction and unstable angina pectoris) are associated with increased mast cell activity, reflected by elevated serum tryptase levels., Methods: Serum levels of tryptase were determined in the following three groups of patients: 13 patients with acute myocardial infarction, 10 patients with unstable angina pectoris, and 14 patients without ischaemic cardiovascular disease who were used as controls. Patients with known IgE mediated allergic diseases and/or anti-histaminical drugs were excluded., Results: The groups were comparable for sex, blood pressure, smoking and cholesterol levels. The controls tended to be younger (P=0.05). Levels of tryptase did not differ between patients with acute myocardial infarction (7.9+/-4.6 microg/l), unstable angina pectoris (6.0+/-2.1 microg/l) or controls (6.9+/-4.1 microg/l), nor could a relation with levels of C-reactive protein be demonstrated., Conclusion: Serum levels of tryptase are not elevated in patients with acute coronary syndromes. This implies that increased mast cell activity, if any, in unstable coronary syndromes is not reflected systemically. Other, more specific methods will be needed to determine the activity of the mast cell in vivo.

Published
2001
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35. An extracellular activator of the Drosophila JAK/STAT pathway is a sex-determination signal element.

Author

Sefton L, Timmer JR, Zhang Y, Béranger F, and Cline TW

Subjects
Animals, Animals, Genetically Modified, Drosophila enzymology, Drosophila physiology, Female, Gene Expression Regulation, Developmental, Genes, Insect, Glycoproteins metabolism, Glycoproteins physiology, Male, Molecular Sequence Data, Regulatory Sequences, Nucleic Acid, Transcription, Genetic, X Chromosome, Drosophila genetics, Drosophila Proteins, Glycoproteins genetics, Protein-Tyrosine Kinases metabolism, RNA-Binding Proteins genetics, Sex Determination Processes, Signal Transduction, Transcription Factors metabolism
Abstract

Metazoans use diverse and rapidly evolving mechanisms to determine sex. In Drosophila melanogaster an X-chromosome-counting mechanism determines the sex of an individual by regulating the master switch gene, Sex-lethal (Sxl). The X-chromosome dose is communicated to Sxl by a set of X-linked signal elements (XSEs), which activate transcription of Sxl through its 'establishment' promoter, SxlPe. Here we describe a new XSE called sisterlessC (sisC) whose mode of action differs from that of previously characterized XSEs, all of which encode transcription factors that activate SxlPe directly. In contrast, sisC encodes a secreted ligand for the Drosophila Janus kinase (JAK) and 'signal transducer and activator of transcription' (STAT) signal transduction pathway and is allelic to outstretched (os, also called unpaired). We conclude that sisC works indirectly on Sxl through this signalling pathway because mutations in sisC or in the genes encoding Drosophila JAK or STAT reduce expression of SxlPe similarly. The involvement of os in sex determination confirms that secreted ligands can function in cell-autonomous processes. Unlike sex signals for other organisms, sisC has acquired its sex-specific function while maintaining non-sex-specific roles in development, a characteristic that it shares with all other Drosophila XSEs.

Published
2000
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