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Coronary Artery Disease: HELP
Articles from Hungary
Based on 111 articles published since 2008
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These are the 111 published articles about Coronary Artery Disease that originated from Hungary during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Editorial Myocardial computed tomography perfusion: a synergy of form and function. 2018

Szilveszter, Bálint / Maurovich-Horvat, Pál. ·Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. ·Eur Heart J Cardiovasc Imaging · Pubmed #30256917.

ABSTRACT: -- No abstract --

2 Editorial The left main stem: The barometer of coronary artery disease severity? 2018

Maurovich-Horvat, Pál. ·MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address: p.maurovich-horvat@cirg.hu. ·J Cardiovasc Comput Tomogr · Pubmed #29759893.

ABSTRACT: -- No abstract --

3 Review The Impact of Obesity on the Cardiovascular System. 2018

Csige, Imre / Ujvárosy, Dóra / Szabó, Zoltán / Lőrincz, István / Paragh, György / Harangi, Mariann / Somodi, Sándor. ·Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Hungary. · Division of Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Hungary. · Division of Clinical Pharmacology, Faculty of Pharmacy, University of Debrecen, Hungary. ·J Diabetes Res · Pubmed #30525052.

ABSTRACT: Obesity is a growing health problem worldwide. It is associated with an increased cardiovascular risk on the one hand of obesity itself and on the other hand of associated medical conditions (hypertension, diabetes, insulin resistance, and sleep apnoea syndrome). Obesity has an important role in atherosclerosis and coronary artery disease. Obesity leads to structural and functional changes of the heart, which causes heart failure. The altered myocardial structure increases the risk of atrial fibrillation and sudden cardiac death. However, obesity also has a protective effect on the clinical outcome of underlying cardiovascular disease, the phenomenon called obesity paradox. The improved cardiac imaging techniques allow the early detection of altered structure and function of the heart in obese patients. In this review, we attempt to summarize the relationship between obesity and cardiovascular diseases and outline the underlying mechanisms. The demonstrated new techniques of cardiac diagnostic procedures allow for the early detection and treatment of subclinical medical conditions and, therefore, the prevention of cardiovascular events.

4 Review Expecting the unexpected: preventing and managing the consequences of coronary perforations. 2018

Tajti, Peter / Xenogiannis, Iosif / Chavez, Ivan / Gössl, Mario / Mooney, Michael / Poulose, Anil / Sorajja, Paul / Traverse, Jay / Wang, Yale / Burke, M Nicholas / Brilakis, Emmanouil S. ·a Minneapolis Heart Institute , Abbott Northwestern Hospital , Minneapolis , MN , USA. · b Division of Invasive Cardiology, Second Department of Internal Medicine and Cardiology Center , University of Szeged , Szeged , Hungary. ·Expert Rev Cardiovasc Ther · Pubmed #30338712.

ABSTRACT: INTRODUCTION: Coronary artery perforations are more likely to occur during percutaneous coronary intervention of complex coronary lesions, such as heavily calcified lesions and chronic total occlusions. Areas covered: Authors provide an update on the management of coronary perforations by performing a critical review of the related, recently published literature. Expert commentary: Meticulous attention to guidewire position and to device selection is critical for minimizing the risk for coronary perforation. If a perforation occurs, following a structured, algorithmic approach can maximize the likelihood of a successful outcome.

5 Review [Hungarian clinical application opportunities of PET/MR imaging and first experiences]. 2018

Tóth, Zoltán / Lukács, Gábor / Cselik, Zsolt / Bajzik, Gábor / Egyed, Miklós / Vajda, Zsolt / Borbély, Katalin / Hadjiev, Janaki / Gyarmati, Tünde / Emri, Miklós / Kovács, Árpád / Repa, Imre. ·PET Medicopus Nonprofit Kft. Kaposvár. · Doktori Iskola, Pécsi Tudományegyetem, Egészségtudományi Kar Pécs. · Onkológiai Osztály, Somogy Megyei Kaposi Mór Oktató Kórház Kaposvár. · Sugárterápiás Osztály, Csolnoky Ferenc Kórház Veszprém. · Egészségügyi Központ, Diagnosztikai és Onkoradiológiai Intézet, Kaposvári Egyetem Kaposvár, Guba S. u. 40., 7400. · Hematológiai Osztály, Somogy Megyei Kaposi Mór Oktató Kórház Kaposvár. · Országos Onkológiai Intézet Budapest. · Klinikai Központ, Orvosi Képalkotó Klinika, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen. ·Orv Hetil · Pubmed #30122057.

ABSTRACT: Hungary's first and still only multimodality PET/MR device is operating in the Health Center of Kaposvár University. The aim of our review article is to present the current Hungarian PET/MR imaging application opportunities, our available initial experiences with this novel multimodality imaging technique in malignant and non-malignant diseases and further potential targeted clinical fields of use are also addressed. Orv Hetil. 2018; 159(34): 1375-1384.

6 Review The year 2017 in the European Heart Journal-Cardiovascular Imaging: Part I. 2018

Popescu, Bogdan A / Petersen, Steffen E / Maurovich-Horvat, Pál / Haugaa, Kristina H / Donal, Erwan / Maurer, Gerald / Edvardsen, Thor. ·Department of Cardiology, University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania. · William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK. · Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK. · MTA-SE Cardiovascular Imaging Research Group (CIRG), Heart and Vascular Center, Semmelweis University, Varosmajor u.68, Budapest, Hungary. · Department of Cardiology, Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, NO-0027 Oslo, Norway. · Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 20, NO-0027 Oslo, Norway. · Cardiology and CIC-IT1414, CHU Rennes, Rennes, France and LTSI INSERM 1099, University Rennes-1, Rennes, France. · Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Spitalgasse 23, Wien, Austria. ·Eur Heart J Cardiovasc Imaging · Pubmed #30085023.

ABSTRACT: The European Heart Journal - Cardiovascular Imaging was launched in 2012. It has gained an impressive impact factor of 8.336 during its first 6 years and is now established as one of the top 10 cardiovascular journals in the world and the most important cardiovascular imaging journal in Europe. The most important studies published in the journal in 2017 will be highlighted in two reports. Part I will focus on studies about myocardial function, coronary artery disease and myocardial ischaemia, and emerging techniques and applications in cardiovascular imaging, whereas Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

7 Review CAD-RADS - a new clinical decision support tool for coronary computed tomography angiography. 2018

Foldyna, Borek / Szilveszter, Bálint / Scholtz, Jan-Erik / Banerji, Dahlia / Maurovich-Horvat, Pál / Hoffmann, Udo. ·Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA, 02114, USA. bfoldyna@mgh.harvard.edu. · Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Center, Leipzig, Germany. bfoldyna@mgh.harvard.edu. · MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. · Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA, 02114, USA. ·Eur Radiol · Pubmed #29116390.

ABSTRACT: Coronary computed tomography angiography (CTA) has been established as an accurate method to non-invasively assess coronary artery disease (CAD). The proposed 'Coronary Artery Disease Reporting and Data System' (CAD-RADS) may enable standardised reporting of the broad spectrum of coronary CTA findings related to the presence, extent and composition of coronary atherosclerosis. The CAD-RADS classification is a comprehensive tool for summarising findings on a per-patient-basis dependent on the highest-grade coronary artery lesion, ranging from CAD-RADS 0 (absence of CAD) to CAD-RADS 5 (total occlusion of a coronary artery). In addition, it provides suggestions for clinical management for each classification, including further testing and therapeutic options. Despite some limitations, CAD-RADS may facilitate improved communication between imagers and patient caregivers. As such, CAD-RADS may enable a more efficient use of coronary CTA leading to more accurate utilisation of invasive coronary angiograms. Furthermore, widespread use of CAD-RADS may facilitate registry-based research of diagnostic and prognostic aspects of CTA. KEY POINTS: • CAD-RADS is a tool for standardising coronary CTA reports. • CAD-RADS includes clinical treatment recommendations based on CTA findings. • CAD-RADS has the potential to reduce variability of CTA reports.

8 Review The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. 2016

Lancellotti, Patrizio / Pellikka, Patricia A / Budts, Werner / Chaudhry, Farooq A / Donal, Erwan / Dulgheru, Raluca / Edvardsen, Thor / Garbi, Madalina / Ha, Jong-Won / Kane, Garvan C / Kreeger, Joe / Mertens, Luc / Pibarot, Philippe / Picano, Eugenio / Ryan, Thomas / Tsutsui, Jeane M / Varga, Albert. ·Department of Cardiology, University of Liège Hospital, GIGA-Cardiovascular Sciences, Liège, Belgium plancellotti@chu.ulg.ac.be. · Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy. · Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. · Congenital and Structural Cardiology University Hospitals Leuven, Leuven. · Echocardiography Laboratories, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, NY, USA. · Service de Cardiologie, CHU RENNES et LTSI U 1099 - Université Rennes-1, Rennes, France. · Department of Cardiology, University of Liège Hospital, GIGA-Cardiovascular Sciences, Liège, Belgium. · Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway. · King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK. · Cardiology Division, Yonsei University College of Medicine, Seoul, South Korea. · Echo Lab, Children's Healthcare of Atlanta, Emory University School of Medicine Atlanta, Georgia, USA. · Echocardiography, The Hospital for Sick Children, University of Toronto, Toronto, Canada. · Québec Heart & Lung Institute/Institut Universitaire de Cardiology et de Pneumologie de Québec, Department of Cardiology, Laval University and Canada Research Chair in Valvular Heart Disease, QC, Canada. · Institute of Clinical Physiology, National Research Council, Pisa, Italy. · Ohio State University, Columbus, OH, USA. · Heart Institute - University of São Paulo Medical School and Fleury Group, São Paulo, Brazil. · Institute of Family Medicine, University of Szeged, Hungary. ·Eur Heart J Cardiovasc Imaging · Pubmed #27880640.

ABSTRACT: A unique and highly versatile technique, stress echocardiography (SE) is increasingly recognized for its utility in the evaluation of non-ischaemic heart disease. SE allows for simultaneous assessment of myocardial function and haemodynamics under physiological or pharmacological conditions. Due to its diagnostic and prognostic value, SE has become widely implemented to assess various conditions other than ischaemic heart disease. It has thus become essential to establish guidance for its applications and performance in the area of non-ischaemic heart disease. This paper summarizes these recommendations.

9 Review Prognostic Value of Coronary Computed Tomography Angiography in Patients With Diabetes: A Meta-analysis. 2016

Celeng, Csilla / Maurovich-Horvat, Pál / Ghoshhajra, Brian B / Merkely, Béla / Leiner, Tim / Takx, Richard A P. ·MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. · Cardiac MR PET CT Program, Division of Cardiovascular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA. · Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands. · Cardiac MR PET CT Program, Division of Cardiovascular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands r.a.p.takx@umcutrecht.nl. ·Diabetes Care · Pubmed #27330128.

ABSTRACT: OBJECTIVE: The usefulness of coronary computed tomography angiography (CTA) for the evaluation of coronary artery disease (CAD) in patients with diabetes is ambiguous. We therefore performed a meta-analysis of studies reporting event rates and hazard ratios (HR) to determine the prognostic value of CTA in this patient population. RESEARCH DESIGN AND METHODS: We searched PubMed and Embase up to November 2015. Study subjects' characteristics, events (all-cause mortality or cardiac death, nonfatal myocardial infarction, unstable angina pectoris, stroke, revascularization), and events excluding revascularization were collected. We calculated the prevalence of obstructive and nonobstructive CAD on CTA, annualized event rates, and pooled unadjusted and adjusted HR using a generic inverse random model. RESULTS: Eight studies were eligible for inclusion into this meta-analysis, with 6,225 participants (56% male; weighted age, 61 years) with a follow-up period ranging from 20 to 66 months. The prevalence of obstructive CAD, nonobstructive CAD, and no CAD was 38%, 36%, and 25%, respectively. The annualized event rate was 17.1% for obstructive CAD, 4.5% for nonobstructive CAD, and 0.1% for no CAD. Obstructive and nonobstructive CAD were associated with an increased HR of 5.4 and 4.2, respectively. A higher HR for obstructive CAD was observed in studies including revascularization compared with those that did not (7.3 vs. 3.7, P = 0.124). CONCLUSIONS: CTA in patients with diabetes allows for safely ruling out future events, and the detection of CAD could allow for the identification of high-risk patients in whom aggressive risk factor modification, medical surveillance, or elective revascularization could potentially improve survival.

10 Review Cardiac allograft vasculopathy: optical coherence guided innovative treatment options with the bioresorbable vascular scaffold: proof of concept. 2016

Édes, István F / Hajas, Ágota / Sax, Balázs / Bartykowszki, Andrea / Becker, Dávid / Merkely, Béla. ·Semmelweis University, Heart and Vascular Center, Budapest, Hungary - edes789@gmail.com. ·Minerva Cardioangiol · Pubmed #27152623.

ABSTRACT: The aim of our work was to assess a novel interventional therapy option in cardiac allograft vasculopathy (CAV), a complex form of coronary disease presenting only in heart transplant (HTx) recipients. It is typically a rapidly progressing phenomenon, affecting the entire coronary circulation causing diffuse, severe coronary lesions and has no one unique cause. Treatment options are limited, but where eligible, palliation via percutaneous revascularization (PCI) mainly using new generation drug eluting stents (DES) is recommended. Our working group sought to assess outcomes of CAV PCI using an Absorb (Abbott Vascular, Santa Clara, CA, USA) fully bioresorbable, everolimus eluting vascular scaffold (BVS), under optical coherence tomography (OCT) guidance. Our initial, proof-of-concept case showed a late CAV, macrophage and foam-cell rich lesion, with typical asymmetric intimal hyperplasia and contralateral thin-cap fibroatheroma formation. Post-PCI OCT showed underexpansion, requiring aggressive postdilatation. Ninety-day follow-up CT angiogram identified the scaffold and displayed a patent lumen of the device. BVS use thus seems eligible in CAV, yet needs proper, meticulous implantation. Use may also delay CAV progression as lesion healing is promoted, with restoration of vasomotion and a natural increase in vascular lumen. Furthermore, the chronically present vascular irritation surrounding stent/scaffold struts may subside, as no permanent metal is present as an increased substrate for inflammation. To assess full efficacy, further studies will be needed.

11 Review Non-invasive and invasive imaging of vulnerable coronary plaque. 2016

Celeng, Csilla / Takx, Richard A P / Ferencik, Maros / Maurovich-Horvat, Pál. ·MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. · Cardiac MR PET CT Program, Division of Cardiovascular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. · Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR. · MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address: p.maurovich-horvat@cirg.hu. ·Trends Cardiovasc Med · Pubmed #27079893.

ABSTRACT: Vulnerable plaque is characterized by a large necrotic core and an overlying thin fibrous cap. Non-invasive imaging modalities such as computed tomography angiography (CTA) and magnetic resonance imaging (MRI) allow for the assessment of morphological plaque characteristics, while positron emission tomography (PET) enables the detection of metabolic activity within the atherosclerotic lesions. Invasive imaging modalities such as intravascular ultrasound (IVUS), optical-coherence tomography (OCT), and intravascular MRI (IV-MRI) display plaques at a high spatial resolution. Near-infrared spectroscopy (NIRS) allows for the detection of chemical components of atherosclerotic plaques. In this review, we describe state-of-the-art non-invasive and invasive imaging modalities and stress the combination of their advantages to identify vulnerable plaque features.

12 Review Plaque assessment by coronary CT. 2016

Szilveszter, Bálint / Celeng, Csilla / Maurovich-Horvat, Pál. ·MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Varosmajor st, Budapest, 1122, Hungary. · MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Varosmajor st, Budapest, 1122, Hungary. p.maurovich-horvat@cirg.hu. ·Int J Cardiovasc Imaging · Pubmed #26280890.

ABSTRACT: Coronary CT angiography (CTA) has emerged as a highly reliable and non-invasive modality for the exclusion of coronary artery disease. Recent technological advancements in coronary CTA imaging allow for robust qualitative and quantitative assessment of atherosclerotic plaques. Furthermore, CTA is a promising modality for functional evaluation of coronary lesions. Individual plaque features, the extent and severity of atherosclerotic plaque burden were proposed to improve cardiovascular risk stratification. It has been suggested that total atherosclerotic plaque burden is a stronger predictor of coronary events than total ischemia burden. The quest to noninvasively detect individual vulnerable plaques still remains. In the current review we sought to summarize state-of-the-art coronary artery plaque assessment by CTA.

13 Review Comprehensive plaque assessment by coronary CT angiography. 2014

Maurovich-Horvat, Pál / Ferencik, Maros / Voros, Szilard / Merkely, Béla / Hoffmann, Udo. ·MTA-SE Lendület Cardiovascular Imaging Research Group, Heart and Vascular Centre, Semmelweis University, 68 Varosmajor ut, 1025 Budapest, Hungary. · Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA 02114. USA. · Stony Brook University, 101 Nicolls Road, Stony Brook, NY 11794 USA. ·Nat Rev Cardiol · Pubmed #24755916.

ABSTRACT: Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future.

14 Review Meta-analysis comparing carvedilol versus metoprolol for the prevention of postoperative atrial fibrillation following coronary artery bypass grafting. 2014

DiNicolantonio, James J / Beavers, Craig J / Menezes, Arthur R / Lavie, Carl J / O'Keefe, James H / Meier, Pascal / Vorobcsuk, András / Aradi, Dániel / Komócsi, András / Chatterjee, Saurav / D'Ascenzo, Fabrizio / Gasparini, Mauro / Brugts, Jasper / Biondi-Zoccai, Giuseppe. ·Department of Preventive Cardiology, Mid America Heart Institute at Saint Luke's Hospital, University of Missouri-Kansas City, Kansas City, Missouri. Electronic address: jjdinicol@gmail.com. · Department of Pharmacy, Centennial Medical Center, Nashville, Tennessee. · Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana. · Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana; Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, Louisiana. · Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri. · The Heart Hospital, University College London Hospitals UCLH, London, United Kingdom. · Department of Interventional Cardiology, Heart Centre, University of Pécs, Hungary. · Department of Interventional Cardiology, Heart Centre, University of Pécs, Hungary; Department of Cardiology, Heart Center, Balatonfüred, Hungary. · Cardiovascular Diseases, St. Luke's - Roosevelt Hospital Center, Division of Cardiology, New York, New York. · Division of Cardiology, Department of Internal Medicine, Città Della Salute e della Scienza, San Giovanni battista, Turin, Italy. · Department of Mathematical Sciences, Politecnico di Torino. · Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. ·Am J Cardiol · Pubmed #24332247.

ABSTRACT: A systematic review and meta-analysis was performed to evaluate the effects of carvedilol versus metoprolol on the incidence of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting in randomized controlled trials. Ovid MEDLINE, PubMed, CENTRAL, and Excepta Medica (EMBASE) were searched up to March 2013 for suitable randomized controlled trials. Data were pooled using random-effects model for pairwise analyses. A total of 4 trials with 601 patients were included in this analysis. Pairwise analyses showed that compared with metoprolol, carvedilol significantly reduced the incidence of postoperative atrial fibrillation (odds ratio 0.50, 95% confidence interval 0.32 to 0.80). In conclusion, compared with metoprolol, carvedilol significantly reduces the incidence of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.

15 Review [Significance of selenium in the pathogenesis and therapy of cardiovascular diseases and those requiring intensive care]. 2013

Koszta, György / Fülesdi, Béla. ·Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Aneszteziológiai és Intenzív Terápiás Tanszék Debrecen Nagyerdei krt. 98. 4032. ·Orv Hetil · Pubmed #24095911.

ABSTRACT: Selenium deficiency results in profound changes in cellular defence mechanisms against oxidative stress, which plays an important role in the development of cardiovascular disease and the associated risk factors. Increased formation and decreased elimination of reactive oxygen radicals contribute to the complicated mechanisms of sepsis and related disorders. Use of selenium in prevention and treatment of the above mentioned conditions is not a new idea, but controversial data were published in relation to both fields recently. The aim of the present review is to summarize the most important results related to this area.

16 Review [Acute coronary syndrome -- 2012]. 2012

Becker, Dávid / Merkely, Béla. ·Semmelweis Egyetem, Általános Orvostudományi Kar Kardiológiai Tanszék - Kardiológiai Központ Budapest Városmajor u. 68. 1122. becker.david@kardio.sote.hu ·Orv Hetil · Pubmed #23248055.

ABSTRACT: The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

17 Review Non-ST elevation myocardial infarction: a new pathophysiological concept could solve the contradiction between accepted cause and clinical observations. 2011

Medvegy, Mihály / Simonyi, G / Medvegy, N / Pécsvárady, Zs. ·Flór Ferenc County Hospital Kistarcsa, Hungary. drmedvegy@hotmail.com ·Acta Physiol Hung · Pubmed #21893464.

ABSTRACT: OBJECTIVE: Despite similarities in the underlying pathologic mechanism non-ST elevation myocardial infarction(NSTEMI) and ST elevation infarction (STEMI) have many differences in their clinical presentation and prognosis. METHOD: A systematic review of the literature about NSTEMI and the blood supply of the myocardium made us form a hypothesis that a further cause also exists in addition to the accepted cause of NSTEMI (subtotal coronaryartery occlusion): an acute, critical increase in an already existing high intramyocardial microvascular resistance. EVIDENCE: Knowledge about microcirculation disturbances in ischemic heart disease and development of microcirculation damage can be fitted in our hypothesis. Various findings and studies can be interpreted only by our hypothesis: hemodynamic findings, ECG changes, autopsy reports and clinical observations about NSTEMI. The latest ones involve the different long-time prognosis and different result of acute revascularization therapy in STEMI and NSTEMI. Regarding the repolarization changes on the ECG NSTEMI shows similarities with other clinical symptoms where increased intramyocardial microvascular resistance can be supposed without coronary artery disease: false positive exercise stress test, supraventricular tachycardia, left ventricular strain and conduction disturbances. CONCLUSION: The acute treatment of NSTEMI should aim to improve the blood inflow to the stiff myocardiumand/or impaired microvascular system and decrease the high microvascular resistance.

18 Review Prognostic significance of high on-clopidogrel platelet reactivity after percutaneous coronary intervention: systematic review and meta-analysis. 2010

Aradi, Dániel / Komócsi, András / Vorobcsuk, András / Rideg, Orsolya / Tokés-Füzesi, Margit / Magyarlaki, Tamás / Horváth, Iván Gábor / Serebruany, Victor L. ·University of Pécs, Heart Institute, Hungary. daniel_aradi@yahoo.com ·Am Heart J · Pubmed #20826265.

ABSTRACT: BACKGROUND: A growing number of observational studies suggest that high on-clopidogrel platelet reactivity (HPR) is associated with recurrent thrombotic events after percutaneous coronary intervention. We aimed to perform an updated systematic review and meta-analysis on the clinical relevance of HPR to summarize the available evidence and to define more precise effect estimates. METHODS: Relevant observational studies published between January 2003 and February 2010 were searched that presented intent-to-treat analyses on the clinical relevance of HPR measured with an adenosine diphosphate (ADP)-specific platelet function assay. The main outcome measures were cardiovascular (CV) death, definite/probable stent thrombosis (ST), nonfatal myocardial infarction (MI), and a composite end point of reported ischemic events. The outcome parameters were pooled with the random-effect model via generic inverse variance weighting. RESULTS: Twenty studies comprising a total number of 9,187 patients qualified. High on-clopidogrel platelet reactivity appeared to be a strong predictor of MI, ST, and the composite end point of reported ischemic events (odds ratios [95% CI]: 3.00 [2.26-3.99], 4.14 [2.74-6.25], and 4.95 [3.34-7.34], respectively; P < .00001 for all cases). According to the meta-analysis, patients with HPR had a 3.4-fold higher risk for CV death compared with patients with normal ADP reactivity (odds ratio 3.35, 95% CI 2.39-4.70, P < .00001). Although there were large differences in the methodology as well as in the definition of HPR between studies, the predicted risk for CV death, MI, or ST was not heterogeneous (I(2): 0%, 0%, and 12%, respectively; P = not significant for all cases). CONCLUSIONS: High on-clopidogrel platelet reactivity, measured by an ADP-specific platelet function assay, is a strong predictor of CV death, MI, and ST in patients after percutaneous coronary intervention.

19 Review Triglyceride level affecting shared susceptibility genes in metabolic syndrome and coronary artery disease. 2010

Kisfali, P / Polgár, N / Sáfrány, E / Sümegi, K / Melegh, B I / Bene, J / Wéber, A / Hetyésy, K / Melegh, B. ·University of Pécs, Department of Medical Genetics, Pécs, Hungary. ·Curr Med Chem · Pubmed #20738247.

ABSTRACT: Metabolic syndrome is characterized primarily by abdominal obesity, high triglyceride- and low HDL cholesterol levels, elevated blood pressure, and increased fasting glucose levels, which are often associated with coronary heart diseases. Several factors, such as physical inactivity, age, and several endocrine and genetic factors can increase the risk of the development of the disease. Gathered evidence shows, that metabolic syndrome is not only a risk factor for cardiovascular disease, but often both of them have the same shared susceptibility genes, as several genetic variants have shown a predisposition to both diseases. Due to the spread of robust genome wide association studies, the number of candidate genes in metabolic syndrome and coronary heart disease susceptibility increases very rapidly. From the growing spectrum of the genes influencing lipid metabolism (like the LPL; PPARA; APOE; APOAI/CIII/AIV genecluster and APOAS5), the current review focuses on shared susceptibility variants involved in triglyceride metabolism and consequently the effects on the circulating triglyceride levels. As the elevated levels of triglycerides can be associated with disease phenotypes, some of these SNPs can have susceptibility features in both metabolic syndrome and in coronary heart disease, thereby some of them can even represent a kind of susceptibility link between metabolic syndrome and coronary artery disease.

20 Review [Preoperative revascularization in high-risk patients undergoing vascular surgery]. 2009

Rácz, Kristóf / Tiszai-Szucs, Tamás / Gál, János / Kertai D, Miklós. ·Semmelweis Egyetem, Altalános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Tanszék Budapest, Hungary. ·Orv Hetil · Pubmed #19218144.

ABSTRACT: Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy have been controversial. The aim of the review was to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.

21 Review The involvement of blood coagulation factor XIII in fibrinolysis and thrombosis. 2008

Muszbek, L / Bagoly, Z / Bereczky, Z / Katona, E. ·Clinical Research Center, Medical and Health Science Center, University of Debrecen, 98 Nagyerdei krt., P.O. Box 40, 4012 Debrecen, Hungary. muszbek@med.unideb.hu ·Cardiovasc Hematol Agents Med Chem · Pubmed #18673233.

ABSTRACT: It has been known for a long time that blood coagulation factor XIII (FXIII) is essential for maintaining haemostasis, its deficiency leads to severe bleeding complication. Biochemical studies have revealed that FXIII is a key regulator of fibrinolysis and, in addition to its role in haemostasis, it has also been implicated in the pathology of arterial and venous thrombosis. Most recently, the polymorphisms in the FXIII subunit genes and their influence on the risk of thrombotic diseases have stirred a lot of interest. This review, besides including the basic biochemistry of FXIII, mainly concentrates on the biochemical and clinical aspects of the involvement of FXIII in fibrinolysis and thrombosis. Biochemical aspects: Basics on the structure and activation of plasma and cellular FXIII. The enzymological features of activated FXIII and its main substrates. The interaction of FXIIIa with fibrinogen/fibrin and with components of the fibrinolytic system. The impact of cross-linked fibrin clot formation on the fibrinolytic processes. The down-regulation of FXIIIa within the fibrin clot. FXIII polymorphisms and their biochemical consequences. Clinical Aspects: FXIII level and the risk of arterial thrombosis (coronary artery disease, peripheral artery disease, ischemic stroke). The effect of FXIII subunit polymorphisms on the risk of arterial thrombotic diseases. The interplay between FXIII polymorphisms and other factors influencing the risk of arterial thrombosis. FXIII and venous thromboembolism.

22 Review Preoperative coronary revascularization in high-risk patients undergoing vascular surgery: a core review. 2008

Kertai, Miklos D. ·Department of Cardiothoracic Anaesthesia, Semmelweis University, Budapest, Hungary. mkertai@hotmail.com ·Anesth Analg · Pubmed #18292413.

ABSTRACT: Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy has been controversial. My aim in this review is to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.

23 Clinical Trial Short-Term Cardioprotective Effects of the Original Perindopril/Amlodipine Fixed-Dose Combination in Patients with Stable Coronary Artery Disease: Results of the PAPA-CAD Study. 2016

Forster, Tamás / Dézsi, Csaba András. ·2nd Department of Medicine and Cardiology Center, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary. forster.tamas@med.u-szeged.hu. · Department of Cardiology, Petz Aladár County Teaching Hospital, Gyor, Hungary. ·Adv Ther · Pubmed #27475811.

ABSTRACT: INTRODUCTION: Long-term therapy with a combination of perindopril and amlodipine has shown a beneficial effect on the morbidity and mortality of patients with stable coronary artery disease (SCAD) and hypertension. On the basis of the antiproliferative, antithrombotic, and antiatherogenic effects of the active substances, we initiated data collection to examine the short-term cardioprotective effect of perindopril/amlodipine fixed-dose combination therapy in this patient group. The aim of this study was to evaluate the effect of perindopril/amlodipine fixed-dose combination on the Canadian Cardiovascular Society (CCS) class and exercise capacity of patients with SCAD in everyday medical practice. METHODS: This was a multicenter, prospective, observational, non-interventional, open-label, 6-month clinical study. Patients attended four visits (inclusion, and at months 1, 3, and 6), and clinical information was collected [risk factors, comorbidities, blood pressure (BP), and heart rate measured at the physician's office, drug treatment, CCS class, adverse events, optional laboratory blood tests, and exercise electrocardiography (ECG)]. RESULTS: This study included 3472 patients. The mean office systolic BP/diastolic BP decreased from 157.5 ± 12.9/92.9 ± 8.6 to 130.3 ± 8.3/79.8 ± 6.1 mmHg (P < 0.0001). During the 6-month study period, a favorable change in CCS grading was observed following treatment with fixed-dose combination perindopril/amlodipine: CCS I, from 42.6% to 71.4%; CCS II, from 46.4% to 26.5%; CCS III, from 10.2% to 2.0%; and CCS IV, from 0.8% to 0.1% (all P < 0.0001). In those patients who had exercise ECG at inclusion and the end of month 6 (n = 197) the mean performance, measured in watts, increased from 88.9 ± 37.9 to 110.5 ± 38.4 W (+24.4%; P < 0.001) and from 7.86 ± 2.95 to 8.78 ± 2.92 metabolic equivalent of task (MET) (+11.7%; P < 0.001). No serious adverse events were reported and the treatment was found to have a positive impact on patients' metabolic profiles. CONCLUSION: The fixed-dose combination of perindopril and amlodipine improved the CCS class and exercise capacity in patients with SCAD after 6 months of treatment. The fixed-dose combination of perindopril and amlodipine can have favorable effects on the cardiovascular system, not only by its BP-lowering effect and its effect on vascular resistance but also through its direct cardiovascular protective effects. FUNDING: Egis Pharmaceuticals. TRIAL REGISTRATION: 21938-1/2011-EKU (698/PI/11.).

24 Clinical Trial Effect of the BET Protein Inhibitor, RVX-208, on Progression of Coronary Atherosclerosis: Results of the Phase 2b, Randomized, Double-Blind, Multicenter, ASSURE Trial. 2016

Nicholls, Stephen J / Puri, Rishi / Wolski, Kathy / Ballantyne, Christie M / Barter, Philip J / Brewer, H Bryan / Kastelein, John J P / Hu, Bo / Uno, Kiyoko / Kataoka, Yu / Herrman, Jean-Paul R / Merkely, Bela / Borgman, Marilyn / Nissen, Steven E. ·South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA, 5001, Australia. stephen.nicholls@sahmri.com. · Department of Cardiovascular Medicine and Cleveland Clinic Coordinating Center for Clinical Research, Cleveland Clinic, Cleveland, OH, USA. · Section of Cardiovascular Research, Baylor College of Medicine and the Methodist DeBakey Heart and Vascular Center, Houston, TX, USA. · University of New South Wales, Sydney, NSW, Australia. · Medstar Research Institute, Hyattsville, MD, USA. · Department of Vascular Medicine, Academic Medical Center, University of Medicine, Amsterdam, The Netherlands. · South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA, 5001, Australia. · Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. · Heart and Vascular Center, Semmelweis University, Budapest, Hungary. ·Am J Cardiovasc Drugs · Pubmed #26385396.

ABSTRACT: BACKGROUND: Bromodomain and extra-terminal (BET) proteins regulate transcription of lipoprotein and inflammatory factors implicated in atherosclerosis. The impact of BET inhibition on atherosclerosis progression is unknown. METHODS: ASSURE was a double-blind, randomized, multicenter trial in which 323 patients with angiographic coronary disease and low high-density lipoprotein cholesterol (HDL-C) levels were randomized in a 3:1 fashion to treatment with the BET protein inhibitor RVX-208 200 mg or placebo for 26 weeks. Plaque progression was measured with serial intravascular ultrasound imaging. Lipid levels, safety, and tolerability were also assessed. RESULTS: During treatment, apolipoprotein (apo)A-I increased by 10.6% with placebo (P < 0.001 compared with baseline) and 12.8% with RVX-208 (P < 0.001 compared with baseline), between groups P = 0.18. HDL-C increased by 9.1% with placebo (P < 0.001 compared with baseline) and 11.1% with RVX-208 (P < 0.001 compared with baseline), between groups P = 0.24. Low-density lipoprotein cholesterol (LDL-C) decreased by 17.9% with placebo (P < 0.001 compared with baseline) and 15.8% with RVX-208 (P < 0.001 compared with baseline), between groups P = 0.55. The primary endpoint, the change in percent atheroma volume, decreased 0.30% in placebo-treated patients (P = 0.23 compared with baseline) and 0.40% in the RVX-208 group (P = 0.08 compared with baseline), between groups P = 0.81. Total atheroma volume decreased 3.8 mm(3) in the placebo group (P = 0.01 compared with baseline) and 4.2 mm(3) in the RVX-208 group (P < 0.001 compared with baseline), P = 0.86 between groups. A greater incidence of elevated liver enzymes was observed in RVX-208-treated patients (7.1 vs. 0%, P = 0.009). CONCLUSION: Administration of the BET protein inhibitor RVX-208 showed no greater increase in apoA-I or HDL-C or incremental regression of atherosclerosis than administration of placebo. TRIAL REGISTRATION: ClinicalTrials.gov identifier-NCT01067820.

25 Clinical Trial ACTH- and cortisol-associated neutrophil modulation in coronary artery disease patients undergoing stent implantation. 2013

Keresztes, Margit / Horváth, Tamás / Ocsovszki, Imre / Földesi, Imre / Serfőző, Gyöngyi / Boda, Krisztina / Ungi, Imre. ·Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary. keresztes.margit@med.u-szeged.hu ·PLoS One · Pubmed #23967262.

ABSTRACT: BACKGROUND: Psychosocial stress and activation of neutrophil granulocytes are increasingly recognized as major risk factors of coronary artery disease (CAD), but the possible relationship of these two factors in CAD patients is largely unexplored. Activation of neutrophils was reported to be associated with stenting; however, the issue of neutrophil state in connection with percutaneous coronary intervention (PCI) is incompletely understood from the aspect of stress and its hypothalamic-pituitary-adrenal axis (HPA) background. Thus, we aimed to study cortisol- and ACTH-associated changes in granulocyte activation in patients undergoing PCI. METHODOLOGY/PRINCIPAL FINDINGS: Blood samples of 21 stable angina pectoris (SAP) and 20 acute coronary syndrome (ACS) patients were collected directly before (pre-PCI), after (post-PCI) and on the following day of PCI (1d-PCI). Granulocyte surface L-selectin, CD15 and (neutrophil-specific) lactoferrin were analysed by flow cytometry. Plasma cortisol, ACTH, and lactoferrin, IL-6 were also assayed. In both groups, pre- and post-PCI ratios of lactoferrin-bearing neutrophils were relatively high, these percentages decreased substantially next day; similarly, 1d-PCI plasma lactoferrin was about half of the post-PCI value (all p≤0.0001). Post-PCI ACTH was reduced markedly next day, especially in ACS group (SAP: p<0.01, ACS: p≤0.0001). In ACS, elevated pre-PCI cortisol decreased considerably a day after stenting (p<0.01); in pre-PCI samples, cortisol correlated with plasma lactoferrin (r∼0.5, p<0.05). In 1d-PCI samples of both groups, ACTH showed negative associations with the ratio of lactoferrin-bearing neutrophils (SAP: r = -0.601, p<0.005; ACS: r = -0.541, p<0.05) and with plasma lactoferrin (SAP: r = -0.435, p<0.05; ACS: r = -0.609, p<0.005). CONCLUSIONS/SIGNIFICANCE: Pre- and post-PCI states were associated with increased percentage of activated/degranulated neutrophils indicated by elevated lactoferrin parameters, the 1d-PCI declines of which were associated with plasma ACTH in both groups. The correlation of plasma cortisol with plasma lactoferrin in the extremely stressed ACS before stenting, however, suggests an association of cortisol with neutrophil activation.

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