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Coronary Artery Disease: HELP
Articles by Eric H. Boersma
Based on 95 articles published since 2008
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Between 2008 and 2019, E. Boersma wrote the following 95 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial EuroIntervention - Methodology and Statistics Review Board. 2013

Boersma, Eric / van Domburg, Ron / Hoeks, Sanne / Kardys, Isabella / Lenzen, Mattie. · ·EuroIntervention · Pubmed #23685290.

ABSTRACT: -- No abstract --

2 Review Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. 2018

Head, Stuart J / Milojevic, Milan / Daemen, Joost / Ahn, Jung-Min / Boersma, Eric / Christiansen, Evald H / Domanski, Michael J / Farkouh, Michael E / Flather, Marcus / Fuster, Valentin / Hlatky, Mark A / Holm, Niels R / Hueb, Whady A / Kamalesh, Masoor / Kim, Young-Hak / Mäkikallio, Timo / Mohr, Friedrich W / Papageorgiou, Grigorios / Park, Seung-Jung / Rodriguez, Alfredo E / Sabik, Joseph F / Stables, Rodney H / Stone, Gregg W / Serruys, Patrick W / Kappetein, Arie Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: s.head@erasmusmc.nl. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Icahn School of Medicine at Mount Sinai, New York, NY, USA; Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON, Canada. · Norwich Medical School University of East Anglia and Norfolk and Norwich University Hospital, Norwich, UK. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Stanford University School of Medicine, Stanford, CA, USA. · Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. · Richard L Roudebush VA Medical Center, Indianapolis, IN, USA. · Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Biostatistics, Erasmus University Medical Center, Rotterdam, Netherlands. · Cardiac Unit, Otamendi Hospital, Buenos Aires, Argentina. · Department Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. · Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK. · Columbia University Medical Center and the Center for Clinical Trials, Cardiovascular Research Foundation, New York, NY, USA. · Imperial College London, London, UK. ·Lancet · Pubmed #29478841.

ABSTRACT: BACKGROUND: Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS: We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CABG with PCI using stents. Eligible studies included patients with multivessel or left main coronary artery disease who did not present with acute myocardial infarction, did PCI with stents (bare-metal or drug-eluting), and had more than 1 year of follow-up for all-cause mortality. In a collaborative, pooled analysis of individual patient data from the identified trials, we estimated all-cause mortality up to 5 years using Kaplan-Meier analyses and compared PCI with CABG using a random-effects Cox proportional-hazards model stratified by trial. Consistency of treatment effect was explored in subgroup analyses, with subgroups defined according to baseline clinical and anatomical characteristics. FINDINGS: We included 11 randomised trials involving 11 518 patients selected by heart teams who were assigned to PCI (n=5753) or to CABG (n=5765). 976 patients died over a mean follow-up of 3·8 years (SD 1·4). Mean Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score was 26·0 (SD 9·5), with 1798 (22·1%) of 8138 patients having a SYNTAX score of 33 or higher. 5 year all-cause mortality was 11·2% after PCI and 9·2% after CABG (hazard ratio [HR] 1·20, 95% CI 1·06-1·37; p=0·0038). 5 year all-cause mortality was significantly different between the interventions in patients with multivessel disease (11·5% after PCI vs 8·9% after CABG; HR 1·28, 95% CI 1·09-1·49; p=0·0019), including in those with diabetes (15·5% vs 10·0%; 1·48, 1·19-1·84; p=0·0004), but not in those without diabetes (8·7% vs 8·0%; 1·08, 0·86-1·36; p=0·49). SYNTAX score had a significant effect on the difference between the interventions in multivessel disease. 5 year all-cause mortality was similar between the interventions in patients with left main disease (10·7% after PCI vs 10·5% after CABG; 1·07, 0·87-1·33; p=0·52), regardless of diabetes status and SYNTAX score. INTERPRETATION: CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. No benefit for CABG over PCI was seen in patients with left main disease. Longer follow-up is needed to better define mortality differences between the revascularisation strategies. FUNDING: None.

3 Review Factors associated with progression of coronary artery disease measured by intravascular ultrasound: systematic review and meta-analysis. 2014

Nascimento, Bruno R / de Sousa, Marcos Roberto / Demarqui, Fábio N / Chamié, Daniel / Marcolino, Milena S / Biondi-Zoccai, Giuseppe / Boersma, Eric / Ribeiro, Antônio L P / Costa, Marco A. ·Serviço de Cardiologia e Cirurgia Cardiovascular do Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Departamento de Clínica Médica da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Programa de Pós-graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Serviço de Cardiologia e Cirurgia Cardiovascular do Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Programa de Pós-graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, and Case Western Reserve University, Cleveland, USA. · Serviço de Cardiologia e Cirurgia Cardiovascular do Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Departamento de Clínica Médica da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy. · Erasmus University Medical Centre, Thoraxcenter, Rotterdam, the Netherlands. · Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, and Case Western Reserve University, Cleveland, USA. Electronic address: Marco.Costa@UHhospitals.org. ·Int J Cardiol · Pubmed #24801090.

ABSTRACT: -- No abstract --

4 Review Cardiovascular risk profile of patients included in stent trials; a pooled analysis of individual patient data from randomised clinical trials: insights from 33 prospective stent trials in Europe. 2011

Vranckx, Pascal / Boersma, Eric / Garg, Scot / Valgimigli, Marco / Van Es, Gerrit-Anne / Goedhart, Dick / Serruys, Patrick W. ·Department of Cardiac Intensive Care & Interventional Cardiology, Hartcentrum, Hasselt, Belgium. ·EuroIntervention · Pubmed #22082582.

ABSTRACT: AIMS: Few data document trends in cardiovascular (CV) risk-factors in patients with or without previous symptomatic CV disease. We assessed the prevalence and trends in (non) modifiable CV risk-factors, and the use of cardioprotective therapies in patients enrolled in coronary stent trials. METHODS AND RESULTS: This analysis included prospective data on 10,253 mainly European adults who were enrolled in 32 coronary stent studies between 1995 and 2006. Data was collected at the time of enrolment using a standardised patient clinical record form, and was analysed by considering three consecutive time periods: 1995-1997 (I), 1998-2002 (II) and 2003-2006 (III) rendering approximately equal numbers per period. Overall the proportion of active smokers remained constant (Period I to III: 28%, 27%, 21%, p=0.45), however the proportion increased in females below 50 years (about 2%/ year, R.RR: 1.20, P: 0.05 period III versus I). Prevalent diabetes increased (16%, 17%, 25%; p=0.029). The prevalence of a body-mass index (BMI) ≥25 kg/m² was high, but no trend was observed (69%, 68%, 70%; p=0.24). The proportion of patients with elevated blood pressure (i.e., ≥140/90 mmHg, in diabetes ≥130/80 mmHg) remained unchanged (55%, 50.%, 53%; p=0.22), despite an increase in the number of patients taking anti-hypertensive agents (84%, 89%, 90%; p=0.30). Conversely, the proportion of patients with elevated total cholesterol (i.e., ≥4.5 mmol/L) decreased (80%, 66%, 52%; p=0.002), which was consistent with the increase in patients taking lipid lowering drugs (32%, 62%, 69%; p=0.083). The portion of patients reaching therapeutic targets for blood lipids improved, but no improvement was seen in blood pressure control (p=0.29). CONCLUSIONS: There is an unmet clinical need in primary and secondary CV prevention in Europe. Patients requiring PCI are an important target population in whom lifestyle changes and aggressive secondary preventative measures should be aimed. Ultimately PCI should open the door towards optimising secondary prevention.

5 Review Tailored therapy of ACE inhibitors in stable coronary artery disease: pharmacogenetic profiling of treatment benefit. 2010

Brugts, Jasper J / Boersma, Eric / Simoons, Maarten L. ·Department of Cardiology, Erasmus MC Thoraxcenter, 's Gravendijkwal 230, Rotterdam, The Netherlands. j.brugts@erasmusmc.nl ·Pharmacogenomics · Pubmed #20712529.

ABSTRACT: Angiotensin-converting enzyme (ACE) inhibitors are among the most commonly used drugs in stable coronary artery disease as these agents have been proven to be effective for reducing the risk of cardiovascular morbidity and mortality. As with other drugs, individual variation in treatment benefit is likely. Such heterogeneity could be used to target ACE-inhibitor therapy to those patients most likely to benefit from treatment. However, prior attempts to target ACE-inhibitor therapy to those patients who are most likely to benefit of such prophylactic treatment in secondary prevention using clinical characteristics or the level of baseline risk appeared not to be useful. A new approach of 'tailored therapy' could be to integrate more patient-specific characteristics, such as the genetic information of patients. Pharmacogenetic research of ACE inhibitors in coronary artery disease patients is at a formative stage, and studies are limited. The Perindopril Genetic association (PERGENE) study is a large pharmacogenetic substudy of the randomized placebo-controlled European trial On Reduction of Cardiac Events with Perindopril in Patients with Stable Coronary Artery disease (EUROPA) trial, aimed to assess the feasibility of pharmacogenetic profiling of ACE-inhibitor therapy by perindopril. This article summarizes the recent findings of the PERGENE study and pharmacogenetic research of the treatment benefit of perindopril in stable coronary artery disease.

6 Review Incidence, pathophysiology, and treatment of complications during dobutamine-atropine stress echocardiography. 2010

Geleijnse, Marcel L / Krenning, Boudewijn J / Nemes, Attila / van Dalen, Bas M / Soliman, Osama I I / Ten Cate, Folkert J / Schinkel, Arend F L / Boersma, Eric / Simoons, Maarten L. ·Erasmus Medical Center, Thoraxcenter Rotterdam, Rotterdam, the Netherlands. m.geleijnse@erasmusmc.nl ·Circulation · Pubmed #20404267.

ABSTRACT: -- No abstract --

7 Review The renin-angiotensin-aldosterone system: approaches to guide angiotensin-converting enzyme inhibition in patients with coronary artery disease. 2009

Brugts, J J / den Uil, C A / Danser, A H J / Boersma, E. ·Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. j.brugts@erasmusmc.nl ·Cardiology · Pubmed #18832826.

ABSTRACT: Drugs that modulate the renin-angiotensin-aldosterone system (RAAS) play an important role in modern cardiovascular prevention strategies. Inhibitors of the RAAS, in particular angiotensin-converting enzyme (ACE) inhibitors, have been proven to be beneficial in specific patient groups, including patients with hypertension, heart failure, diabetes mellitus and stable coronary artery disease. Although clinical trials demonstrated a rather consistent beneficial effect of ACE inhibitors across groups of patients based on clinical characteristics, the variability in treatment response on the individual patient level is extensive. Recent publications suggest that genetic polymorphisms in the RAAS are related to cardiovascular risk. Genetic variability also seems associated with the response to ACE inhibitor therapy, and can probably be used to tailor treatment. This review discusses several approaches to guide ACE inhibitor therapy in patients with coronary artery disease. In addition, the potential impact of pharmacogenetics regarding this particular topic is highlighted.

8 Review Pharmacogenetics of ACE inhibition in stable coronary artery disease: steps towards tailored drug therapy. 2008

Brugts, Jasper J / Danser, A H Jan / de Maat, Moniek P M / den Uil, Corstiaan A / Boersma, Eric / Ferrari, Roberto / Simoons, Maarten L. ·Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. j.brugts@erasmusmc.nl ·Curr Opin Cardiol · Pubmed #18520711.

ABSTRACT: PURPOSE OF REVIEW: Several trials demonstrated that angiotensin-converting enzyme inhibitors reduce the incidence of cardiovascular events during long-term follow-up in high-risk and low-risk patients. Clinical treatment guidelines propose that angiotensin-converting enzyme inhibitors should be considered in the routine secondary prevention in the broad group of coronary artery disease patients. This review discusses several approaches to guide angiotensin-converting enzyme-inhibition therapy to more specific groups of patients that are most likely to benefit. RECENT FINDINGS: The beneficial effect of angiotensin-converting enzyme inhibition has been shown to be consistent across subgroups in stable coronary artery disease. Still, large interindividual variability in blood pressure response is well documented. It should also be realized that the absolute treatment effects are modest. The efficiency and cost-effectiveness of this prolonged prophylactic treatment would be significantly enhanced if those patients can be distinguished who benefit most. Recently, it was suggested that markers of an activated renin-angiotensin-aldosterone system might be used to guide angiotensin-converting enzyme-inhibition therapy. SUMMARY: At the start of treatment, clinical characteristics are not sufficient to distinguish between patients who will and will not benefit from angiotensin-converting enzyme inhibitors. Although pharmacogenetic research in coronary artery disease is still in a premature stage, it may be expected to provide a useful tool in optimizing and individualizing the management of angiotensin-converting enzyme-inhibitor therapy in coronary artery disease patients.

9 Clinical Trial Prevalence of Subclinical Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography in 45- to 55-Year-Old Women With a History of Preeclampsia. 2018

Zoet, Gerbrand A / Benschop, Laura / Boersma, Eric / Budde, Ricardo P J / Fauser, Bart C J M / van der Graaf, Yolanda / de Groot, Christianne J M / Maas, Angela H E M / Roeters van Lennep, Jeanine E / Steegers, Eric A P / Visseren, Frank L / van Rijn, Bas B / Velthuis, Birgitta K / Franx, Arie / Anonymous1291118. ·Wilhelmina Children's Hospital Birth Center (G.A.Z., B.B.v.R., A.F.) g.zoet@umcutrecht.nl a.franx-2@umcutrecht.nl. · Department of Obstetrics and Gynaecology (L.B., E.A.P.S.). · Department of Cardiology (E.B., R.P.J.B.). · Department of Radiology (R.P.J.B.). · Department of Reproductive Medicine and Gynaecology (B.C.J.M.G.). · Julius Center for Health Sciences and Primary Care (Y.v.d.G.). · Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, Netherlands (G.J.M.d.G.). · Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (A.H.E.M.M.). · Department of Internal Medicine (J.E.R.v.L.), Erasmus Medical Center, Rotterdam, Netherlands. · Department of Vascular Medicine (F.L.V.). · Wilhelmina Children's Hospital Birth Center (G.A.Z., B.B.v.R., A.F.). · Academic Unit of Human Development and Health, University of Southampton, Southampton, United Kingdom (B.B.v.R.). · Department of Radiology (B.K.V.), University Medical Center Utrecht, Netherlands. ·Circulation · Pubmed #29459475.

ABSTRACT: -- No abstract --

10 Clinical Trial Integrated Biomarker and Imaging Study 3 (IBIS-3) to assess the ability of rosuvastatin to decrease necrotic core in coronary arteries. 2016

Oemrawsingh, Rohit M / Garcia-Garcia, Hector M / van Geuns, Robert J M / Lenzen, Mattie J / Simsek, Cihan / de Boer, Sanneke P M / Van Mieghem, Nicolas M / Regar, Evelyn / de Jaegere, Peter P T / Akkerhuis, K Martijn / Ligthart, Jurgen M R / Zijlstra, Felix / Serruys, Patrick W / Boersma, Eric. ·Thoraxcenter, Department of Cardiology, Erasmus MC and Cardiovascular Research Institute (COEUR), Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #27542785.

ABSTRACT: AIMS: Statins are highly effective in reducing major adverse clinical events, but the direct effects on coronary plaque composition remain debatable. Our aim was to mechanistically evaluate the treatment effect of high-intensity statin therapy on compositional coronary plaque changes. METHODS AND RESULTS: The third Integrated Biomarker and Imaging Study (IBIS-3) was a prospective, investigator-initiated, single-centre study. Serial radiofrequency intravascular ultrasound (RF-IVUS) measurements of a predefined non-stenotic segment in a non-culprit coronary artery were performed to evaluate the effect of rosuvastatin (intended dose: 40 mg daily) on necrotic core (NC) volume in patients with stable angina or acute coronary syndrome. Changes in lipid core burden index (LCBI) were evaluated through serial near-infrared spectroscopy (NIRS) imaging in a subset. Serial RF-IVUS (and NIRS) data of a median segment of 41 mm (interquartile range: 32 to 49 mm) were complete in 164 (103) patients. Follow-up measurements were performed at six and 12 months in 30 (26) and 134 (77) patients, respectively. Mean levels of low-density lipoprotein cholesterol decreased by 30%, from 2.49 mmol/l to 1.73 mmol/l at the end of follow-up. High-dose rosuvastatin therapy resulted in a non-significant change of -1.4 mm3 (95% CI: -3.0, 0.1) in NC volume during follow-up (p=0.074). The change in NC percentage of total plaque volume was -1.4% (95% CI: -2.4 to -0.4; p=0.006). A neutral effect was also observed on LCBI. Indications of significant regression of NC volume and LCBI in the highest baseline quartiles were observed, which should cautiously be regarded as hypothesis-generating. CONCLUSIONS: High-intensity rosuvastatin therapy during one year resulted in a neutral effect on NC and LCBI within non-stenotic, non-culprit coronary segments with a relatively low atheroma burden. This study has been registered in The Netherlands Trial Register (NTR) nr. 2872.

11 Clinical Trial Plasma concentrations of molecular lipid species in relation to coronary plaque characteristics and cardiovascular outcome: Results of the ATHEROREMO-IVUS study. 2015

Cheng, Jin M / Suoniemi, Matti / Kardys, Isabella / Vihervaara, Terhi / de Boer, Sanneke P M / Akkerhuis, K Martijn / Sysi-Aho, Marko / Ekroos, Kim / Garcia-Garcia, Hector M / Oemrawsingh, Rohit M / Regar, Evelyn / Koenig, Wolfgang / Serruys, Patrick W / van Geuns, Robert-Jan / Boersma, Eric / Laaksonen, Reijo. ·Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands; ICIN Netherlands Heart Institute, Utrecht, the Netherlands. · Zora Biosciences, Espoo, Finland. · Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands. · Cardialysis, Rotterdam, the Netherlands. · Department of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany. · Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardialysis, Rotterdam, the Netherlands; Imperial College, International Center of Circulatory Health, London, United Kingdom. · Erasmus MC, Department of Cardiology, Rotterdam, the Netherlands; Cardiovascular Research School Erasmus University Rotterdam, Rotterdam, the Netherlands. Electronic address: h.boersma@erasmusmc.nl. · Zora Biosciences, Espoo, Finland; University Hospital, Tampere, Finland; Medical School University of Tampere, Finland. Electronic address: reijo.laaksonen@zora.fi. ·Atherosclerosis · Pubmed #26523994.

ABSTRACT: BACKGROUND AND AIMS: Previous lipidomics analyses have demonstrated that several lipid molecules in plasma are associated with fatal outcome in patients with coronary artery disease (CAD). This study aims to investigate the associations of previously identified high risk lipid molecules in plasma with coronary plaque characteristics derived from intravascular ultrasound virtual histology (IVUS-VH) imaging, with coronary lipid core burden index (LCBI) on near-infrared spectroscopy (NIRS), and with one year cardiovascular outcome in patients with CAD. METHODS: Between 2008 and 2011, IVUS-VH imaging of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography for acute coronary syndrome (ACS) or stable CAD. NIRS imaging was additionally performed in 191 patients. Plasma concentrations of molecular lipids were measured with mass spectrometry. RESULTS: Several cholesteryl ester, ceramide and lactosylceramide species and ceramide ratios were associated with vulnerable plaque characteristics on IVUS-VH and NIRS imaging and with 1-year major adverse cardiac events (MACE, defined as all-cause mortality, ACS and unplanned coronary revascularization). In particular, ceramide d18:1/16:0 was consistently associated with higher necrotic core fraction on IVUS-VH (p = 0.001), higher LCBI (p = 0.024) on NIRS and higher MACE rate (adjusted HR 1.79 per standard deviation increase in log-transformed lipid concentration, 95%CI 1.24-2.59, p = 0.002). CONCLUSION: Several molecular lipid species, and particularly ceramide(d18:1/16:0), are associated with the fraction of necrotic core tissue and lipid core burden in coronary atherosclerosis, and are predictive for 1-year clinical outcome after coronary angiography. These molecular lipids may improve risk stratification in CAD and may also be interesting therapeutic targets for the treatment of atherosclerotic disease.

12 Clinical Trial In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome: results of the ATHEROREMO-IVUS study. 2014

Cheng, Jin M / Garcia-Garcia, Hector M / de Boer, Sanneke P M / Kardys, Isabella / Heo, Jung Ho / Akkerhuis, K Martijn / Oemrawsingh, Rohit M / van Domburg, Ron T / Ligthart, Jurgen / Witberg, Karen T / Regar, Evelyn / Serruys, Patrick W / van Geuns, Robert-Jan / Boersma, Eric. ·Department of Cardiology, Erasmus MC, Rotterdam, Room Bd-381, PO Box 2040, 3000, the Netherlands. ·Eur Heart J · Pubmed #24255128.

ABSTRACT: AIMS: Acute coronary syndromes (ACS) are mostly caused by plaque rupture. This study aims to investigate the prognostic value of in vivo detection of high-risk coronary plaques by intravascular ultrasound (IVUS) in patients undergoing coronary angiography. METHODS AND RESULTS: Between November 2008 and January 2011, IVUS of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography for ACS (n = 318) or stable angina (n = 263). Primary endpoint was major adverse cardiac events (MACEs) defined as mortality, ACS, or unplanned coronary revascularization. Culprit lesion-related events were not counted. Cumulative Kaplan-Meier incidence of 1-year MACE was 7.8%. The presence of IVUS virtual histology-derived thin-cap fibroatheroma (TCFA) lesions (present 10.8% vs. absent 5.6%; adjusted HR: 1.98, 95% CI: 1.09-3.60; P = 0.026) and lesions with a plaque burden of ≥70% (present 16.2% vs. absent 5.5%; adjusted HR: 2.90, 95% CI: 1.60-5.25; P < 0.001) were independently associated with a higher MACE rate. Thin-cap fibroatheroma lesions were also independently associated with the composite of death or ACS only (present 7.5% vs. absent 3.0%; adjusted HR: 2.51, 95% CI: 1.15-5.49; P = 0.021). Thin-cap fibroatheroma lesions with a plaque burden of ≥70% were associated with a higher MACE rate within (P = 0.011) and after (P < 0.001) 6 months of follow-up, while smaller TCFA lesions were only associated with a higher MACE rate after 6 months (P = 0.033). CONCLUSION: In patients undergoing coronary angiography, the presence of IVUS virtual histology-derived TCFA lesions in a non-culprit coronary artery is strongly and independently predictive for the occurrence of MACE within 1 year, particularly of death and ACS. Thin-cap fibroatheroma lesions with a large plaque burden carry higher risk than small TCFA lesions, especially on the short term.

13 Clinical Trial Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: an ATHEROREMO sub-study. 2011

Sarno, Giovanna / Garg, Scot / Gomez-Lara, Josep / Garcia Garcia, Hector M / Ligthart, Jurgen / Bruining, Nico / Onuma, Yoshinobu / Witberg, Karen / van Geuns, Robert-Jan / de Boer, Sanneke / Wykrzykowska, Joanna / Schultz, Carl / Duckers, Henricus J / Regar, Evelyn / de Jaegere, Peter / de Feyter, Pim / van Es, Gerrit Anne / Boersma, Eric / van der Giessen, Wim / Serruys, Patrick W / Anonymous150687. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #21330246.

ABSTRACT: AIMS: To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA). METHODS AND RESULTS: After optimal PCI result (residual stenosis by QCA<30%), IVUS-VH was performed in 100 patients by protocol, with the option to use the information left to the discretion of the operators. Patients were categorised as: Group1 (n=54), where the IVUS-VH findings were used to evaluate the need for further optimisation of the stent deployment; and Group2 (n=46), where the IVUS-VH was documentary such that the stenting results were considered optimal according to QCA. Optimal stent deployment on IVUS-VH was defined as: normal stent expansion, absence of stent malapposition, complete lesion coverage as indicated by a plaque burden (PB%) between 30-40% and necrotic core confluent to the lumen<10% or PB%<30% at the 5 mm proximal and distal to the stent. The first IVUS-VH in all patients demonstrated the achievement of optimal stent deployment, incomplete lesion coverage, stent under-expansion and stent-edge dissection in 60%, 31%, 20% and 8% of patients, respectively. There was no stent malapposition. In Group 1, 25 patients had optimal stent deployment and did not require further intervention, whilst in 29 patients further intervention was needed (additional stent, n=18; post-dilatation, n=29). Overall optimal stent deployment was finally achieved in 52/54 patients (96%) in Group 1 and 35/46 (76%) of Group 2, p<0.05. CONCLUSIONS: IVUS-VH may have a role in facilitating optimal stent implantation and complete lesion coverage.

14 Article Adiponectin in Relation to Coronary Plaque Characteristics on Radiofrequency Intravascular Ultrasound and Cardiovascular Outcome. 2018

Marino, Bárbara Campos Abreu / Buljubasic, Nermina / Akkerhuis, Martijn / Cheng, Jin M / Garcia-Garcia, Hector M / Regar, Evelyn / Geuns, Robert-Jan van / Serruys, Patrick W / Boersma, Eric / Kardys, Isabella. ·Department of Cardiology, Erasmus MC, Rotterdam - the Netherlands. · Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil. · Washington Hospital Center, Washington DC - USA. · University Hospital of Zurich, Zurich - Switzerland. · Imperial College, London - United Kingdom. ·Arq Bras Cardiol · Pubmed #30379252.

ABSTRACT: BACKGROUND: Prospective data on the associations of adiponectin with in-vivo measurements of degree, phenotype and vulnerability of coronary atherosclerosis are currently lacking. OBJECTIVE: To investigate the association of plasma adiponectin with virtual histology intravascular ultrasound (VH-IVUS)-derived measures of atherosclerosis and with major adverse cardiac events (MACE) in patients with established coronary artery disease. METHODS: In 2008-2011, VH-IVUS of a non-culprit non-stenotic coronary segment was performed in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS, n = 318) or stable angina pectoris (SAP, n = 263) from the atherosclerosis-intravascular ultrasound (ATHEROREMO-IVUS) study. Blood was sampled prior to coronary angiography. Coronary plaque burden, tissue composition, high-risk lesions, including VH-IVUS-derived thin-cap fibroatheroma (TCFA), were assessed. All-cause mortality, ACS, unplanned coronary revascularization were registered during a 1-year-follow-up. All statistical tests were two-tailed and p-values < 0.05 were considered statistically significant. RESULTS: In the full cohort, adiponectin levels were not associated with plaque burden, nor with the various VH-tissue types. In SAP patients, adiponectin levels (median[IQR]: 2.9(1.9-3.9) µg/mL) were positively associated with VH-IVUS derived TCFA lesions, (OR[95%CI]: 1.78[1.06-3.00], p = 0.030), and inversely associated with lesions with minimal luminal area (MLA) ≤ 4.0 mm2 (OR[95%CI]: 0.55[0.32-0.92], p = 0.025). In ACS patients, adiponectin levels (median[IQR]: 2.9 [1.8-4.1] µg/mL)were not associated with plaque burden, nor with tissue components. Positive association of adiponectin with death was present in the full cohort (HR[95%CI]: 2.52[1.02-6.23], p = 0.045) and (borderline) in SAP patients (HR[95%CI]: 8.48[0.92-78.0], p = 0.058). In ACS patients, this association lost statistical significance after multivariable adjustment (HR[95%CI]: 1.87[0.67-5.19], p = 0.23). CONCLUSION: In the full cohort, adiponectin levels were associated with death but not with VH-IVUS atherosclerosis measures. In SAP patients, adiponectin levels were associated with VH-IVUS-derived TCFA lesions. Altogether, substantial role for adiponectin in plaque vulnerability remains unconfirmed.

15 Article IgM anti-malondialdehyde low density lipoprotein antibody levels indicate coronary heart disease and necrotic core characteristics in the Nordic Diltiazem (NORDIL) study and the Integrated Imaging and Biomarker Study 3 (IBIS-3). 2018

van den Berg, Victor J / Haskard, Dorian O / Fedorowski, Artur / Hartley, Adam / Kardys, Isabella / Caga-Anan, Mikhail / Akkerhuis, K Martijn / Oemrawsingh, Rohit M / van Geuns, Robert Jan / de Jaegere, Peter / van Mieghem, Nicolas / Regar, Evelyn / Ligthart, Jurgen M R / Umans, Victor A W M / Serruys, Patrick W / Melander, Olle / Boersma, Eric / Khamis, Ramzi Y. ·Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands; Netherlands Heart Institute (NHI), Utrecht, The Netherlands. · National Heart and Lung Institute, Imperial College, London, United Kingdom. · Department of Clinical Sciences, Malmö, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands. · Department of Clinical Sciences, Malmö, Lund University, Clinical Research Center, Malmö, Sweden. · National Heart and Lung Institute, Imperial College, London, United Kingdom. Electronic address: r.khamis@imperial.ac.uk. ·EBioMedicine · Pubmed #30131305.

ABSTRACT: Background: Certain immunoglobulins (Ig) are proposed to have protective functions in atherosclerosis. Objectives: We tested whether serum levels of IgG and IgM autoantibodies against malondialdehyde low density lipoprotein (MDA-LDL) are associated with clinical coronary heart disease (CHD) and unfavorable plaque characteristics. Methods: NORDIL was a prospective study investigating adverse cardiovascular outcomes in hypertensive patients. IBIS-3 analyzed lesions in a non-culprit coronary artery with <50% stenosis using radiofrequency intravascular ultrasound (RF-IVUS) and near-infrared spectroscopy (NIRS). Imaging was repeated after a median of 386?days on rosuvastatin. Associations of antibodies with incident CHD and imaging parameters were assessed in the two sub-studies respectively. Findings: From 10,881 NORDIL patients, 87 had serum sampled at baseline and developed CHD over 4.5 years, matched to 227 controls. Higher titers of IgM anti-MDA-LDL had a protective effect on adverse outcomes, with odds ratio 0.29 (0.11, 0.76; p=0.012; p=0.016 for trend). Therefore, the effect was explored at the lesional level in IBIS-3. 143 patients had blood samples and RF-IVUS measurements available, and NIRS was performed in 90 of these. At baseline, IgM anti-MDA-LDL levels had a strong independent inverse relationship with lesional necrotic core volume (p=0.027) and percentage of plaque occupied by necrotic core (p=0.011), as well as lipid core burden index (p=0.024) in the worst 4 mm segment. Interpretation: Our study supports the hypothesis that lower circulating levels of IgM anti-MDA-LDL are associated with clinical CHD development, and for the first time relates these findings to atherosclerotic plaque characteristics that are linked to vulnerability.

16 Article SYNTAX score II predicts long-term mortality in patients with one- or two-vessel disease. 2018

Vroegindewey, Maxime M / Schuurman, Anne-Sophie / Oemrawsingh, Rohit M / van Geuns, Robert-Jan / Kardys, Isabella / Ligthart, Jurgen / Daemen, Joost / Boersma, Eric / Serruys, Patrick W / Akkerhuis, K Martijn. ·Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands. · Department of Cardiology, Imperial College, London, United Kingdom. ·PLoS One · Pubmed #29965993.

ABSTRACT: OBJECTIVE: SYNTAX score II (SSII) is a long-term mortality prediction model to guide the decision making of the heart-team between coronary artery bypass grafting or percutaneous coronary intervention (PCI) in patients with left main or three-vessel coronary artery disease. This study aims to investigate the long-term predictive value of SSII for all-cause mortality in patients with one- or two-vessel disease undergoing PCI. METHODS: A total of 628 patients (76% men, mean age: 61±10 years) undergoing PCI due to stable angina pectoris (43%) or acute coronary syndrome (57%), included between January 2008 and June 2013, were eligible for the current study. SSII was calculated using the original SYNTAX score website (www.syntaxscore.com). Cox regression analysis was used to assess the association between continuous SSII and long-term all-cause mortality. The area under the receiver-operating characteristic curve was used to assess the performance of SSII. RESULTS: SSII ranged from 6.6 to 58.2 (median: 20.4, interquartile range: 16.1-26.8). In multivariable analysis, SSII proved to be an independent significant predictor for 4.5-year mortality (hazard ratio per point increase: 1.10; 95% confidence interval: 1.07-1.13; p<0.001). In terms of discrimination, SSII had a concordance index of 0.77. CONCLUSION: In addition to its established value in patients with left main and three-vessel disease, SSII may also predict long-term mortality in PCI-treated patients with one- or two-vessel disease.

17 Article Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study. 2018

van Boven, Nick / van Domburg, Ron T / Kardys, Isabella / Umans, Victor A / Akkerhuis, K Martijn / Lenzen, Mattie J / Valgimigli, Marco / Daemen, Joost / Zijlstra, Felix / Boersma, Eric / van Geuns, Robert-Jan. ·Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands. · Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. ·Catheter Cardiovasc Interv · Pubmed #28707322.

ABSTRACT: OBJECTIVES: We aimed to develop a model to predict long-term mortality after percutaneous coronary intervention (PCI), to aid in selecting patients with sufficient life expectancy to benefit from bioabsorbable scaffolds. BACKGROUND: Clinical trials are currently designed to demonstrate superiority of bioabsorbable scaffolds over metal devices up to 5 years after implantation. METHODS: From 2000 to 2011, 19.532 consecutive patients underwent PCI in a tertiary referral hospital. Patients were randomly (2:1) divided into a training (N = 13,090) and validation (N = 6,442) set. Cox regression was used to identify determinants of long-term mortality in the training set and used to develop a risk model. Model performance was studied in the training and validation dataset. RESULTS: Median age was 63 years (IQR 54-72) and 72% were men. Median follow-up was 3.6 years (interquartile range [IQR] 2.4-6.8). The ratio elective vs. non-elective PCIs was 42/58. During 88,620 patient-years of follow-up, 3,156 deaths occurred, implying an incidence rate of 35.6 per 1,000. Estimated 5-year mortality was 12.9%.Regression analysis revealed age, body mass index, diabetes mellitus, renal insufficiency, prior myocardial infarction, PCI indication, lesion location, number of diseased vessels and cardiogenic shock at presentation as determinants of mortality. The long-term risk model showed good discrimination in the training and validation sets (c-indices 0.76 and 0.74), whereas calibration was appropriate. CONCLUSIONS: A simple risk model, containing 9 baseline clinical and angiographic variables effectively predicts long-term mortality after PCI and may possibly be used to select suitable patients for bioabsorbable scaffolds.

18 Article Long-Term Outcomes of Stenting the Proximal Left Anterior Descending Artery in the PROTECT Trial. 2017

Roguin, Ariel / Camenzind, Edoardo / Kerner, Arthur / Beyar, Rafael / Boersma, Eric / Mauri, Laura / Steg, Ph Gabriel / Wijns, William. ·Rambam Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: aroguin@technion.ac.il. · Institut Lorrain du Coeur et des Vaisseaux, Vandoeuvre-les-Nancy, France; Université de Lorraine, Nancy, France. · Rambam Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. · Erasmus Medical Center, Rotterdam, the Netherlands. · Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts. · Département Hospitalo-Universitaire FIRE, Paris, France; Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Bichat, Paris, France; NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom. · Cardiovascular Research Center, OLV Hospital, Aalst, Belgium. ·JACC Cardiovasc Interv · Pubmed #28335893.

ABSTRACT: OBJECTIVES: This study sought to compare the outcomes of patients undergoing drug-eluting stent implantation according to lesion location within or outside the proximal left anterior descending (LAD) artery. BACKGROUND: Proximal LAD artery involvement is considered uniquely in revascularization guidelines. The impact of LAD lesion location on long-term outcomes after revascularization is poorly understood in context of current percutaneous coronary intervention and medical therapy. METHODS: Among 8,709 patients enrolled in PROTECT (Patient Related Outcomes with Endeavor Versus Cypher Stenting Trial), a multicenter percutaneous coronary intervention trial, we compared the outcomes of 2,534 patients (29.1%) (3,871 lesions [31.5%]) with stents implanted in the proximal LAD to 6,172 patients (70.9%) (8,419 lesions [68.5%]) with stents implanted outside the proximal LAD. RESULTS: At the 4-year follow-up, death rates were the same (5.8% vs. 5.8%; p > 0.999), but more myocardial infarctions occurred in the proximal LAD group (6.2% vs. 4.9%; p = 0.015). The rate of clinically driven target vessel failure (TVF) (14.8% vs. 13.5%; p = 0.109), major adverse cardiac event(s) (MACE) (15.0% vs. 13.7%; hazard ratio: 1.1; 95% confidence interval: 0.97 to 1.31; p = 0.139), and stent thrombosis (2.1% vs. 2.0%; p = 0.800) were similar. Drug-eluting stent type had no interaction with MACE or TVF. In multivariate analysis, the proximal LAD was a predictor of myocardial infarction (p = 0.038) but not of TVF (p = 0.149) or MACE (p = 0.069). CONCLUSIONS: In this study of contemporary percutaneous coronary intervention, proximal LAD location was associated with higher rates of myocardial infarction during the long-term follow-up, but there were no differences in stent thrombosis, death, TVF, or overall MACE. This finding may suggest that, in the drug-eluting stent era, proximal LAD no longer confers a different prognosis than other lesion sites. (Randomized Study Comparing Endeavor With Cypher Stents [PROTECT]; NCT00476957).

19 Article Early ventricular tachyarrhythmias after coronary artery bypass grafting surgery: Is it a real burden? 2017

Mouws, Elisabeth M J P / Yaksh, Ameeta / Knops, Paul / Kik, Charles / Boersma, Eric / Bogers, Ad J J C / de Groot, Natasja M S. ·Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Department of Cardio-thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardio-thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. Electronic address: nmsdegroot@yahoo.com. ·J Cardiol · Pubmed #28069327.

ABSTRACT: BACKGROUND: The prevalence of ventricular dysrhythmias (VD) [ventricular premature beats (VPBs), ventricular couplets (Vcouplets), ventricular runs (Vruns)] after coronary artery bypass grafting (CABG) has so far not been examined. The goal of this study is to examine characteristics of VD and whether they precede ventricular tachyarrhythmias (VTA) during a postoperative follow-up period of 5 days using continuous rhythm registrations. In addition, we determined predictive factors of VD/VTA. METHODS: Incidences and burdens of VD/VTA were calculated in patients (N=105, 83 male, 65±9 years) undergoing primary, on-pump CABG. Independent risk factors were examined using multivariate analysis. RESULTS: VPBs, Vcouplets, and Vruns occurred in respectively 100%, 82.9%, and 48.6% with corresponding burdens of 0.05%, 0%, and 0%. Sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) did not occur in our cohort. Independent risk factors for VD included male gender, mitral valve insufficiency, hyperlipidemia, and age ≥60 years. CONCLUSIONS: VD are common in patients with coronary artery disease after CABG. Despite high incidences of these dysrhythmias, corresponding burdens are low and sustained VT or VF did not occur. Incidences were highest on the first postoperative day and diminished over time.

20 Article Sex differences in plaque characteristics by intravascular imaging in patients with coronary artery disease. 2017

Ten Haaf, Monique E / Rijndertse, Melissa / Cheng, Jin M / de Boer, Sanneke P / Garcia-Garcia, Hector M / van Geuns, Robert-Jan M / Regar, Evelyn / Lenzen, Mattie J / Appelman, Yolande / Boersma, Eric. ·Department of Cardiology, VU University Medical Center Amsterdam, Amsterdam, the Netherlands. ·EuroIntervention · Pubmed #27867141.

ABSTRACT: AIMS: We aimed to study sex differences in coronary plaque burden and plaque composition in patients with coronary artery disease (CAD). METHODS AND RESULTS: Virtual histology intravascular ultrasound (VH-IVUS) and near-infrared spectroscopy (NIRS) imaging of a non-culprit coronary artery was performed in 178 (23.5%) women and 581 (76.5%) men who underwent invasive management of stable angina pectoris (SAP) or acute coronary syndrome (ACS). Women were older and had a worse cardiovascular risk profile than men, but less extended angiographic coronary disease. Irrespective of the presenting diagnosis, women had lower VH-IVUS-derived plaque burden than men (38.1% vs. 40.5% in SAP, and 35.9% vs. 38.8% in ACS). Standardised (mean 211 vs. 263 mm3 in SAP, and 199 vs. 245 mm3 in ACS) total plaque volume was lower in women. Volumes of fibrous tissue, fibro-fatty tissue, necrotic core and dense calcium were also lower in women. NIRS-derived lipid core burden index (LCBI) was lower in women, in particular in SAP (mean LCBI in the worst 4 mm 220 vs. 240). The observed differences remained significant after adjustment for clinical characteristics. CONCLUSIONS: Women had more favourable plaque characteristics than men, despite their worse risk profile. Long-term follow-up studies are required to evaluate the clinical consequences.

21 Article Fibrinogen in relation to degree and composition of coronary plaque on intravascular ultrasound in patients undergoing coronary angiography. 2017

Buljubasic, Nermina / Akkerhuis, K Martijn / Cheng, Jin M / Oemrawsingh, Rohit M / Garcia-Garcia, Hector M / de Boer, Sanneke P M / Regar, Evelyn / van Geuns, Robert-Jan M / Serruys, Patrick W J C / Boersma, Eric / Kardys, Isabella. ·Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands. ·Coron Artery Dis · Pubmed #27755007.

ABSTRACT: OBJECTIVE: The aim of this study was to provide additional insight into the role of fibrinogen in coronary artery disease by investigating the associations between plasma fibrinogen with both degree and composition of coronary atherosclerosis as determined by virtual histology-intravascular ultrasound. PATIENTS AND METHODS: In 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris, preprocedural blood samples were drawn for fibrinogen, C-reactive protein (CRP), interleukin-6, and plasminogen activator inhibitor-1 measurements, and virtual histology-intravascular ultrasound of a nonculprit coronary artery was performed. The degree [plaque volume, plaque burden (PB), and lesions with PB≥70%] and the composition of coronary atherosclerotic plaque (fibrous, fibrofatty, dense calcium, necrotic core tissue, and thin-cap fibroatheroma lesions) were assessed. RESULTS: Fibrinogen showed a tendency toward a positive association with PB [β (95% CI): 2.55 (-0.52-5.61) increase in PB per ln(g/l) fibrinogen, P=0.09], which was driven significantly by an association in the ACS subgroup [β (95% CI): 4.11 (0.01-8.21) increase in PB per ln(g/l) fibrinogen, P=0.049]. Fibrinogen was also related to the presence of lesions with PB 70% or more in both the full cohort [OR (95% CI): 2.27 (1.17-4.43), P=0.016] and ACS patients [OR (95% CI): 2.92 (1.17-7.29), P=0.022]. All associations were independent of established cardiovascular risk factors, but not CRP. Interleukin-6 and plasminogen activator inhibitor-1 did not provide incremental value to fibrinogen when examining the associations with degree of atherosclerosis. Substantial associations with plaque composition were absent. CONCLUSION: Fibrinogen is associated with degree of coronary atherosclerosis, especially in ACS patients. However, whether this association is independent of CRP might be questioned and needs further investigation.

22 Article Cohort profile of BIOMArCS: the BIOMarker study to identify the Acute risk of a Coronary Syndrome-a prospective multicentre biomarker study conducted in the Netherlands. 2016

Oemrawsingh, Rohit M / Akkerhuis, K Martijn / Umans, Victor A / Kietselaer, Bas / Schotborgh, Carl / Ronner, Eelko / Lenderink, Timo / Liem, Anho / Haitsma, David / van der Harst, Pim / Asselbergs, Folkert W / Maas, Arthur / Oude Ophuis, Anton J / Ilmer, Ben / Dijkgraaf, Rene / de Winter, Robbert-Jan / The, S Hong Kie / Wardeh, Alexander J / Hermans, Walter / Cramer, Etienne / van Schaik, Ron H / Hoefer, Imo E / Doevendans, Pieter A / Simoons, Maarten L / Boersma, Eric. ·Erasmus MC, Rotterdam, The Netherlands. · Cardiovascular Research Institute COEUR, Rotterdam, The Netherlands. · Netherlands Heart Institute/Interuniversity Cardiology Institute Netherlands, Utrecht, The Netherlands. · Medical Center Alkmaar, Alkmaar, The Netherlands. · Maastricht University Medical Center, Maastricht, The Netherlands. · HagaZiekenhuis, The Hague, The Netherlands. · Reinier de Graaf Hospital, Delft, The Netherlands. · Zuyderland Hospital, Heerlen, The Netherlands. · Sint Franciscus Gasthuis, Rotterdam, The Netherlands. · Admiraal de Ruyter Hospital, Goes, The Netherlands. · University of Groningen, University Medical Center Groningen, The Netherlands. · Division Heart & Lungs, Department of Cardiology, UMC Utrecht, Utrecht, The Netherlands. · Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, The Netherlands. · Faculty of Population Health Sciences, Institute of Cardiovascular Science, University College London, London, UK. · Gelre Hospital, Zutphen, The Netherlands. · Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. · Working Group on Cardiovascular Research the Netherlands (WCN), Utrecht, The Netherlands. · Havenziekenhuis, Rotterdam, The Netherlands. · St. Jansdal Hospital, Harderwijk, The Netherlands. · Academic Medical Center, Amsterdam, The Netherlands. · Treant Zorggroep, locatie Bethesda, Hoogeveen, The Netherlands. · Medisch Centrum Haaglanden location Westeinde, Den Haag, The Netherlands. · St. Elisabeth Hospital, Tilburg, The Netherlands. · Radboud University Medical Center, Nijmegen, The Netherlands. ·BMJ Open · Pubmed #28011810.

ABSTRACT: PURPOSE: Progression of stable coronary artery disease (CAD) towards acute coronary syndrome (ACS) is a dynamic and heterogeneous process with many intertwined constituents, in which a plaque destabilising sequence could lead to ACS within short time frames. Current CAD risk assessment models, however, are not designed to identify increased vulnerability for the occurrence of coronary events within a precise, short time frame at the individual patient level. The BIOMarker study to identify the Acute risk of a Coronary Syndrome (BIOMArCS) was designed to evaluate whether repeated measurements of multiple biomarkers can predict such 'vulnerable periods'. PARTICIPANTS: BIOMArCS is a multicentre, prospective, observational study of 844 patients presenting with ACS, either with or without ST-elevation and at least one additional cardiovascular risk factor. METHODS AND ANALYSIS: We hypothesised that patterns of circulating biomarkers that reflect the various pathophysiological components of CAD, such as distorted lipid metabolism, vascular inflammation, endothelial dysfunction, increased thrombogenicity and ischaemia, diverge in the days to weeks before a coronary event. Divergent biomarker patterns, identified by serial biomarker measurements during 1-year follow-up might then indicate 'vulnerable periods' during which patients with CAD are at high short-term risk of developing an ACS. Venepuncture was performed every fortnight during the first half-year and monthly thereafter. As prespecified, patient enrolment was terminated after the primary end point of cardiovascular death or hospital admission for non-fatal ACS had occurred in 50 patients. A case-cohort design will explore differences in temporal patterns of circulating biomarkers prior to the repeat ACS. FUTURE PLANS AND DISSEMINATION: Follow-up and event adjudication have been completed. Prespecified biomarker analyses are currently being performed and dissemination through peer-reviewed publications and conference presentations is expected from the third quarter of 2016. Should identification of a 'vulnerable period' prove to be feasible, then future research could focus on event reduction through pharmacological or mechanical intervention during such periods of high risk for ACS. TRIAL REGISTRATION NUMBER: NTR1698 and NTR1106.

23 Article Plasma cystatin C and neutrophil gelatinase-associated lipocalin in relation to coronary atherosclerosis on intravascular ultrasound and cardiovascular outcome: Impact of kidney function (ATHEROREMO-IVUS study). 2016

Brankovic, Milos / Akkerhuis, K Martijn / Buljubasic, Nermina / Cheng, Jin M / Oemrawsingh, Rohit M / Garcia-Garcia, Hector M / Regar, Evelyn / Serruys, Patrick W / van Geuns, Robert-Jan / Boersma, Eric / Kardys, Isabella. ·Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Netherlands Heart Institute, Utrecht, The Netherlands. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. Electronic address: i.kardys@erasmusmc.nl. ·Atherosclerosis · Pubmed #27680774.

ABSTRACT: BACKGROUND AND AIMS: We investigated whether plasma cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) are associated with intravascular ultrasound (IVUS)-derived characteristics of coronary atherosclerosis and 1-year adverse coronary events in patients with normal and mildly-to-moderately impaired kidney function. METHODS: Between 2008 and 2011, virtual histology (VH)-IVUS of a non-culprit coronary artery was performed in 581 patients undergoing coronary angiography. Creatinine, CysC and NGAL were measured in pre-procedural blood samples. Presence of VH-IVUS-derived thin-cap fibroatheroma (TCFA) lesions, lesions with plaque burden (PB)≥70% and lesions with minimal luminal area (MLA)≤4 mm RESULTS: In patients with normal kidney function, those with higher CysC levels had fewer lesions with PB ≥ 70% and fewer VH-TCFA lesions (adjusted odds ratios (ORs) and 95% confidence intervals (CIs): 0.46 [0.30-0.69] and 0.59 [0.44-0.83], respectively, per standard deviation (SD) ln[ng/mL] CysC). Those with higher NGAL levels also had fewer lesions with PB ≥ 70% (adjusted OR [95% CI]:0.49 [0.29-0.82]) In patients with impaired kidneys, no differences in high-risk lesions were observed for CysC or NGAL. However, those with higher CysC had higher risk of MACE (hazard ratio (HR):1.4, 95% CI [1.03-1.92]). This was not the case in patients with normal kidney function. NGAL did not influence risk of MACE. CONCLUSIONS: Mild-to-moderate kidney dysfunction modifies the relationship between CysC and high-risk coronary lesions. This has not been established before, and offers an explanation for the difference in findings between experimental and epidemiologic studies.

24 Article Frequency of Stent Thrombosis Risk at 5 Years in Women Versus Men With Zotarolimus-Eluting Compared With Sirolimus-Eluting Stent. 2016

Ten Haaf, Monique / Appelman, Yolande / Wijns, William / Steg, Gabriel / Mauri, Laura / Rademaker-Havinga, Tessa / Wetzels, Gwenn / Bousquette, Lisa / Camenzind, Edoardo / Boersma, Eric / Anonymous5340879. ·Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Netherlands Heart Institute, Utrecht, The Netherlands. · Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. · Cardiovascular Center, OLV Hospital, Aalst, Belgium. · Department of Cardiology, Hopital Bichat Assistance Publique, Paris, France. · Department of Cardiology, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts. · Cardialysis BV, Rotterdam, The Netherlands. · Medtronic Bakken Research Center, Medtronic Cardiovascular, Maastricht, The Netherlands. · Medtronic Cardiovascular, Santa Rosa, California. · Department of Cardiology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Cardiovascular research school COEUR, Erasmus MC, Rotterdam, The Netherlands. Electronic address: h.boersma@erasmusmc.nl. ·Am J Cardiol · Pubmed #27569387.

ABSTRACT: The prevalence of factors that are associated with an increased risk of stent thrombosis (ST), including smoking, diabetes mellitus, and small stent size, is different in women and men who underwent percutaneous coronary intervention. Thus, gender may potentially modify the relation between stent type and the incidence of ST during long-term follow-up. We explored the data of Patient Related Outcomes With Endeavor Versus Cypher stenting Trial (PROTECT) to evaluate this hypothesis. PROTECT randomized 2,061 women and 6,648 men who underwent percutaneous coronary intervention for various indications to Endeavor zotarolimus-eluting stenting (E-ZES) or Cypher sirolimus-eluting stenting (C-SES). Dual antiplatelet therapy was prescribed for at least 3 months. Data on study end points were collected until 5 years after randomization, including ST, death, and cardiovascular events. We analyzed end points and treatment effect (E-ZES vs C-SES) in relation to gender. Women were on average 4.7 years older (65.8 vs 61.1), had a higher prevalence of insulin-dependent diabetes mellitus, were less often smokers, and had a shorter total stent length than men. At discharge and throughout follow-up, a slightly lower fraction of women were using dual antiplatelet therapy. During 5-year follow-up, definite or probable ST was observed in 36 women (1.8%) and 152 men (2.4%; log-rank p = 0.15). E-ZES reduced the incidence of ST compared with C-SES in women (hazard ratio 0.58) and men (hazard ratio 0.61), with no evidence of heterogeneity (p = 0.89). In conclusion, in PROTECT, women and men had similar cumulative incidence of ST at 5 years after stent placement. The favorable effect of the study stent E-ZES over C-SES was not modified by gender.

25 Article Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival. 2016

Ultee, Klaas H J / Hoeks, Sanne E / Gonçalves, Frederico Bastos / Boersma, Eric / Stolker, Robert Jan / Verhagen, Hence J M / Rouwet, Ellen V. ·Department of Vascular Surgery, Erasmus University Medical Center, The Netherlands. · Department of Anaesthesiology, Erasmus University Medical Center, The Netherlands. · Department of Vascular Surgery, Erasmus University Medical Center, The Netherlands; Department of Angiology and Vascular Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. · Department of Cardiology, Erasmus University Medical Center, The Netherlands. · Department of Vascular Surgery, Erasmus University Medical Center, The Netherlands. Electronic address: e.rouwet@erasmusmc.nl. ·Atherosclerosis · Pubmed #27544931.

ABSTRACT: BACKGROUND AND AIMS: Although it has become clear that aneurysmal and occlusive arterial disease represent two distinct etiologic entities, it is still unknown whether the two vascular pathologies are prognostically different. We aim to assess the long-term vital prognosis of patients with abdominal aortic aneurysmal disease (AAA) or peripheral artery disease (PAD), focusing on possible differences in survival, prognostic risk profiles and causes of death. METHODS: Patients undergoing elective surgery for isolated AAA or PAD between 2003 and 2011 were retrospectively included. Differences in postoperative survival were determined using Kaplan-Meier and Cox regression analysis. Prognostic risk profiles were also established with Cox regression analysis. RESULTS: 429 and 338 patients were included in the AAA and PAD groups, respectively. AAA patients were older (71.7 vs. 63.3 years, p < 0.001), yet overall survival following surgery did not differ (HR: 1.16, 95% CI: 0.87-1.54). Neither was type of vascular disease associated with postoperative cardiovascular nor cancer-related death. However, in comparison with age- and gender-matched general populations, cardiovascular mortality was higher in PAD than AAA patients (48.3% vs. 17.3%). Survival of AAA and PAD patients was negatively affected by age, history of cancer and renal insufficiency. Additional determinants in the PAD group were diabetes and ischemic heart disease. CONCLUSIONS: Long-term survival after surgery for PAD and AAA is similar. However, overall life expectancy is significantly worse among PAD patients. The contribution of cardiovascular disease towards mortality in PAD patients warrants more aggressive secondary prevention to reduce cardiovascular mortality and improve longevity.

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