Acute coronary syndromes in patients with pre-existing moderate to severe valvular disease of the heart: lessons from the Euro-Heart Survey of acute coronary syndromes.

Abstract:

AIM:To determine the frequency of pre-existing valvular disease (VD) among patients with acute coronary syndromes (ACS) and to compare the clinical characteristics, clinical course, treatment, and outcomes of ACS patients with and without pre-existing VD. METHODS AND RESULTS:The Euro Heart Survey ACS prospectively enrolled 10,484 ACS patients in 103 hospitals in 25 countries across Europe and the Mediterranean basin. Of the 10,207 patients with data on VD status, 489 (4.8%) had a diagnosis of pre-existing VD: 3.7% of 4339 ST-segment-elevation-ACS patients, 5.2% of 5210 non-ST-segment-elevation-ACS patients, and 10.8% of 658 undetermined-electrocardiogram-ACS patients. Moderate/severe mitral regurgitation had been diagnosed in 54.0% (48.7% without and 5.3% with concomitant mitral stenosis), and moderate/severe aortic stenosis occurred in 31.7% (26.4% without and 5.3% with concomitant aortic regurgitation). Patients with pre-existing VD had worse baseline clinical and demographic characteristics, were more likely to present with heart failure and less likely to have typical angina, and had a more complicated in-hospital course (heart failure, atrial arrhythmias, and renal failure). They were more likely to receive inotropic agents, diuretics, amiodarone, and warfarin, and less likely to receive antiplatelet agents and beta-adrenergic blockers. As compared to patients without VD, the adjusted risk (95% confidence interval) of in-hospital death for VD patients was 1.55 (0.85, 2.80), 1.92 (1.03, 3.59), and 1.77 (0.75, 4.17) for ST-segment-elevation-ACS, non-ST-segment-elevation-ACS, and undetermined-electrocardiogram-ACS, respectively. CONCLUSIONS:Patients with ACS and pre-existing VD constitute about 5% of all ACS patients; they have high-risk features and poor prognosis. There is a need to better define their optimal treatment, in order to improve their prognosis.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Hasdai D,Lev EI,Behar S,Boyko V,Danchin N,Vahanian A,Battler A

doi

10.1016/s0195-668x(02)00742-x

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

623-9

issue

7

eissn

0195-668X

issn

1522-9645

pii

S0195668X0200742X

journal_volume

24

pub_type

杂志文章
  • A new Alliance: biomedical societies in Europe unite to support research.

    abstract::After years of stagnant finances for research, moves are under way to increase research funds in Europe. ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:

    authors: Smith U,Sipido K,Dive C,Nicod L

    更新日期:2011-09-01 00:00:00

  • Combined aortic, mitral and tricuspid surgery: results in 78 patients.

    abstract::Between 1968 and 1984, 78 patients (mean age 43, range 14 to 65 years) underwent combined aortic, mitral and tricuspid surgery (22 triple valve replacements, 56 aortic valve replacements with tricuspid conservative surgery and mitral valve replacement (N = 48), or commissuroplasty (N = 8). Pre-operative consequences o...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a062305

    authors: Michel PL,Houdart E,Ghanem G,Badaoui G,Hage A,Acar J

    更新日期:1987-05-01 00:00:00

  • Influence of coronary vessel dominance on short- and long-term outcome in patients after ST-segment elevation myocardial infarction.

    abstract:AIMS:Prognostic importance of coronary vessel dominance in patients with ST-elevation myocardial infarction (STEMI) remains uncertain. The aim of this study was to assess influence of coronary vessel dominance on the short- and long-term outcome after STEMI. METHODS AND RESULTS:Coronary angiographic images of consecut...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehu236

    authors: Veltman CE,van der Hoeven BL,Hoogslag GE,Boden H,Kharbanda RK,de Graaf MA,Delgado V,van Zwet EW,Schalij MJ,Bax JJ,Scholte AJ

    更新日期:2015-05-01 00:00:00

  • Mononuclear cell secretome protects from experimental autoimmune myocarditis.

    abstract:AIMS:Supernatants of serum-free cultured mononuclear cells (MNC) contain a mix of immunomodulating factors (secretome), which have been shown to attenuate detrimental inflammatory responses following myocardial ischaemia. Inflammatory dilated cardiomyopathy (iDCM) is a common cause of heart failure in young patients. E...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehs459

    authors: Hoetzenecker K,Zimmermann M,Hoetzenecker W,Schweiger T,Kollmann D,Mildner M,Hegedus B,Mitterbauer A,Hacker S,Birner P,Gabriel C,Gyöngyösi M,Blyszczuk P,Eriksson U,Ankersmit HJ

    更新日期:2015-03-14 00:00:00

  • Environmental tobacco smoke and cardiometabolic risk in young children: results from a survey in south-west Germany.

    abstract:AIMS:We explored the association between exposure to environmental tobacco smoke (ETS) and various cardiometabolic biomarkers in 10-year-old children. METHODS AND RESULTS:A population-based cross-sectional study was carried out. Data on ETS exposure and potential confounders were collected by parental questionnaire. A...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehp180

    authors: Nagel G,Arnold FJ,Wilhelm M,Link B,Zoellner I,Koenig W

    更新日期:2009-08-01 00:00:00

  • Acute effects of angiotensin-converting enzyme inhibition on coronary vasomotion in hypertensive patients.

    abstract::Coronary vasodilator responses to pharmacological (acetylcholine) and physiological (cold pressor test and flow dependent dilation) stimuli are impaired in hypertensive patients. The ability of angiotensin-converting enzyme inhibitors to restore normal coronary responses in hypertension and the potential mechanisms in...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:

    authors: Nitenberg A,Antony I

    更新日期:1998-09-01 00:00:00

  • A mechanism of cardiac pain suppression by spinal cord stimulation: implications for patients with angina pectoris.

    abstract::Clinical reports show that electrical stimulation of the spinal cord reduces symptoms of angina pectoris, but so far have not provided evidence on the mechanisms involved. The hypothesis for this study was that inhibition of spinothalamic tract transmission may account for this result. Extracellular potentials of 28 s...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/14.1.96

    authors: Chandler MJ,Brennan TJ,Garrison DW,Kim KS,Schwartz PJ,Foreman RD

    更新日期:1993-01-01 00:00:00

  • Myocardial ischaemia in the hypertensive patient--the role of coronary microcirculation abnormalities.

    abstract::Clinicians have long suspected that hypertrophied hearts have an inadequate coronary circulation. This clinical suspicion resulted from the observation that a large proportion of patients with left ventricular hypertrophy who have normal coronary arteriograms complain of angina and have ischaemia-like ST segment depre...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:

    authors: Kaski JC

    更新日期:1993-11-01 00:00:00

  • Heart failure syndrome. Rationale for current drug treatment.

    abstract::In the initial phase of heart failure, cardiac output and pressure are maintained by increasing sympathetic drive and by cell hypertrophy. Elevated end-diastolic volume, a reduced ejection fraction and a higher filling pressure also occur. Only in more severe heart failure, when cardiac output cannot be maintained, do...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/16.suppl_f.2

    authors: Burkart F

    更新日期:1995-07-01 00:00:00

  • Prediction of outcome by neurohumoral activation, the six-minute walk test and the Minnesota Living with Heart Failure Questionnaire in an outpatient cohort with congestive heart failure.

    abstract:AIMS:To compare the precursor of atrial and brain natriuretic peptide (N-ANP, N-BNP), brain natriuretic peptide (BNP), big endothelin-1, the 6-min walk test and the Minnesota Living with Heart Failure Questionnaire (LHFQ) with regard to short-term outcome in an ambulatory heart failure population. METHODS AND RESULTS:...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1053/euhj.2001.3115

    authors: Hülsmann M,Berger R,Sturm B,Bojic A,Woloszczuk W,Bergler-Klein J,Pacher R

    更新日期:2002-06-01 00:00:00

  • Acute effects of cigarette smoking on platelet-dependent thrombin generation.

    abstract:AIMS:Thrombin is an important factor in the pathogenesis of thrombotic diseases. To clarify whether smoking has an effect in platelet-dependent thrombogenesis, we studied the acute effects of smoking on platelet-dependent thrombin level in smokers. METHODS AND RESULTS:Subjects consisted of ten smokers and nine non-smo...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1053/euhj.1999.1938

    authors: Hioki H,Aoki N,Kawano K,Homori M,Hasumura Y,Yasumura T,Maki A,Yoshino H,Yanagisawa A,Ishikawa K

    更新日期:2001-01-01 00:00:00

  • ACE inhibitors in non-ischaemic heart failure: results from the MEGA trials.

    abstract::Large-scale trials have demonstrated a consistent mortality reduction from angiotensin converting enzyme (ACE) inhibitor therapy for chronic heart failure. Nonetheless, the pharmacologic and physiologic mechanisms of this favourable affect and the appropriate target population remain controversial. ACE inhibitors exer...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/16.suppl_o.133

    authors: Cohn JN

    更新日期:1995-12-01 00:00:00

  • In vivo heating of pacemaker leads during magnetic resonance imaging.

    abstract:AIMS:Magnetic resonance imaging (MRI) is well established as an important diagnostic tool in medicine. However, the presence of a cardiac pacemaker is usually regarded as a contraindication for MRI due to safety reasons. In this study, heating effects at the myocardium-pacemaker lead tip interface have been investigate...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehi009

    authors: Luechinger R,Zeijlemaker VA,Pedersen EM,Mortensen P,Falk E,Duru F,Candinas R,Boesiger P

    更新日期:2005-02-01 00:00:00

  • Fractional flow reserve and pressure-bounded coronary flow reserve to predict outcomes in coronary artery disease.

    abstract:Aims:Fractional flow reserve (FFR) has proven to its prognostic and therapeutic value. However, the additive prognostic value of coronary flow reserve (CFR) remains unclear. This study sought to investigate the clinical utility of combined FFR and CFR measurements to predict outcomes. Methods and results:Using the pro...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehx139

    authors: Ahn JM,Zimmermann FM,Johnson NP,Shin ES,Koo BK,Lee PH,Park DW,Kang SJ,Lee SW,Kim YH,Lee CW,Park SW,Pijls NHJ,Park SJ

    更新日期:2017-07-01 00:00:00

  • No effect of PCSK9 inhibitor alirocumab on the incidence of diabetes in a pooled analysis from 10 ODYSSEY Phase 3 studies.

    abstract:AIMS:Statins have modest adverse effects on glycaemic control. Alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, lowers low-density lipoprotein cholesterol. This study assessed the effects of alirocumab on new-onset diabetes and pre-diabetes incidence in individuals without diabetes at baseline. M...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehw292

    authors: Colhoun HM,Ginsberg HN,Robinson JG,Leiter LA,Müller-Wieland D,Henry RR,Cariou B,Baccara-Dinet MT,Pordy R,Merlet L,Eckel RH

    更新日期:2016-10-14 00:00:00

  • Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better.

    abstract:AIMS:Our objectives were (i) to compare the discriminatory performance of the Thrombolysis in Myocardial Infarction risk score (TIMI RS), Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy risk score (PURSUIT RS), and Global Registry of Acute Cardiac Events risk score (GRAC...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehm004

    authors: Yan AT,Yan RT,Tan M,Casanova A,Labinaz M,Sridhar K,Fitchett DH,Langer A,Goodman SG

    更新日期:2007-05-01 00:00:00

  • The immediate effect of nitroglycerin on total body blood volume distribution in patients with congestive heart failure: a non-invasive study.

    abstract::The effect of sublingually administered nitroglycerin (0.5 mg) on distribution of blood volume in 16 patients with congestive heart failure (NYHA class II and III), randomly assigned to placebo (N = 8) or nitroglycerin (N = 8) was studied 20 minutes after in vivo labelling of red blood cells with 99m-Tc pertechnetate....

    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/oxfordjournals.eurheartj.a062177

    authors: Schneider AJ,Teule GJ,Groeneveld AB,Nauta J,Luth WJ,Thijs LG

    更新日期:1987-10-01 00:00:00

  • Telemonitoring in chronic heart failure.

    abstract::Clinical management of refractory heart failure remains challenging, with a high rate of rehospitalizations despite advances in medical and device therapy. Care can be provided in person, via telehomecare (by telephone), or telemonitoring, which involves wireless technology for remote follow-up. Telemonitoring wireles...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/ehr005

    authors: Hasan A,Paul V

    更新日期:2011-06-01 00:00:00

  • Ergometric evaluation of physical fitness of athletes affected by mitral valve prolapse: study of 80 cases.

    abstract::Physical fitness of athletes affected by mitral valve prolapse (MVP) was examined, in order to evaluate the influence of sport activity on the natural history of the disease. Maximal workload, total workload, percentage efficiency (according to Hollmann's formula), double product of maximal cycloergometric stress test...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/8.suppl_d.33

    authors: Musante R,Cupelli V,Mori F,Attinà DA

    更新日期:1987-08-01 00:00:00

  • Myocardial infarction and the myocyte IGF1 autocrine system.

    abstract::To determine the effects of acute myocardial infarction on the extent and distribution of mural stress on surviving myocardial tissue, coronary artery occlusion was surgically produced in rats. Following haemodynamic measurements in vivo, the characteristics of cardiac anatomy were determined and found to consist of a...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/16.suppl_n.37

    authors: Anversa P,Reiss K,Kajstura J,Cheng W,Li P,Sonnenblick EH,Olivetti G

    更新日期:1995-12-01 00:00:00

  • Failure of provision of antibiotic prophylaxis for 'at risk' cardiac patients: impetus for improvement required from cardiologists.

    abstract::We conducted a survey by questionnaire to assess whether patients 'at risk' from infective endocarditis are aware of the need for good dental hygiene and antibiotic prophylaxis, and receive appropriate advice or treatment. Of 189 patients surveyed, half had told a dentist about their heart, 8% were aware of a dental p...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/14.6.812

    authors: Forbat LN,Skehan JD

    更新日期:1993-06-01 00:00:00

  • Stage-dependent differential effects of interleukin-1 isoforms on experimental atherosclerosis.

    abstract:AIMS:Targeting interleukin-1 (IL-1) represents a novel therapeutic approach to atherosclerosis. CANTOS demonstrated the benefits of IL-1β neutralization in patients post-myocardial infarction with residual inflammatory risk. Yet, some mouse data have shown a prominent role of IL-1α rather than IL-1β in atherosclerosis,...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehz008

    authors: Vromman A,Ruvkun V,Shvartz E,Wojtkiewicz G,Santos Masson G,Tesmenitsky Y,Folco E,Gram H,Nahrendorf M,Swirski FK,Sukhova GK,Libby P

    更新日期:2019-08-07 00:00:00

  • Endothelial mineralocorticoid receptor activation mediates endothelial dysfunction in diet-induced obesity.

    abstract:AIMS:Aldosterone plays a crucial role in cardiovascular disease. 'Systemic' inhibition of its mineralocorticoid receptor (MR) decreases atherosclerosis by reducing inflammation and oxidative stress. Obesity, an important cardiovascular risk factor, is an inflammatory disease associated with increased plasma aldosterone...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/eht095

    authors: Schäfer N,Lohmann C,Winnik S,van Tits LJ,Miranda MX,Vergopoulos A,Ruschitzka F,Nussberger J,Berger S,Lüscher TF,Verrey F,Matter CM

    更新日期:2013-12-01 00:00:00

  • Effects of simvastatin only or in combination with continuous combined hormone replacement therapy on serum lipid levels in hypercholesterolaemic post-menopausal women.

    abstract:AIMS:To evaluate the effects of simvastatin only or combined with continuous hormone replacement therapy on the serum lipid profile in hypercholesterolaemic post-menopausal women. METHODS AND RESULTS:One hundred hypercholesterolaemic post-menopausal women were given either simvastatin 10 mg daily together with oestrog...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1053/euhj.1999.1582

    authors: Fak AS,Erenus M,Tezcan H,Caymaz O,Atagündüz P,Oktay S,Oktay A

    更新日期:2000-02-01 00:00:00

  • Impaired microcirculation predicts poor outcome of patients with acute myocardial infarction complicated by cardiogenic shock.

    abstract:AIMS:we investigated the relationship between sublingual perfused capillary density (PCD) as a measure of tissue perfusion and outcome (i.e. occurrence of organ failure and mortality) in patients with cardiogenic shock from acute myocardial infarction. METHODS AND RESULTS:we performed a prospective study in 68 patient...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehq324

    authors: den Uil CA,Lagrand WK,van der Ent M,Jewbali LS,Cheng JM,Spronk PE,Simoons ML

    更新日期:2010-12-01 00:00:00

  • Repeat percutaneous coronary angioplasty; clinical and angiographic follow-up in patients with stable or unstable angina pectoris.

    abstract::This study analyses the immediate outcome and the risk of recurrent restenosis in patients who, at the time of repeat coronary angioplasty for a first restenosis, had unstable (n = 50), 19%) or stable (n = 218, 81%) angina. Successful angioplasty was accomplished in 250 (93%) patients, 222 (89%) of whom had follow-up ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/14.2.235

    authors: Bauters C,Lablanche JM,McFadden EP,Leroy F,Bertrand ME

    更新日期:1993-02-01 00:00:00

  • Role of programmed ventricular stimulation in patients with Brugada syndrome: a meta-analysis of worldwide published data.

    abstract:AIMS:Brugada syndrome (BS) is an ion channelopathy with the risk of sudden cardiac death. The role of programmed ventricular stimulation (PVS) in risk stratification has been controversially discussed. Therefore, we performed a meta-analysis on the prognostic role of PVS in BS. METHODS AND RESULTS:A Medline search unt...

    journal_title:European heart journal

    pub_type: 杂志文章,meta分析,评审

    doi:10.1093/eurheartj/ehm116

    authors: Paul M,Gerss J,Schulze-Bahr E,Wichter T,Vahlhaus C,Wilde AA,Breithardt G,Eckardt L

    更新日期:2007-09-01 00:00:00

  • Effects of the new class III antiarrhythmic drug dofetilide on the atrial and ventricular intracardiac monophasic action potential in patients with angina pectoris.

    abstract::The class III antiarrhythmic drug dofetilide is known to prolong action potential duration by specific blockade of the delayed rectifier potassium channel Ik. As dofetilide is likely to be used in the treatment of atrial arrhythmias it is important to determine the relative sensitivity of the atrium and ventricle in m...

    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/oxfordjournals.eurheartj.a060790

    authors: Sedgwick ML,Dalrymple I,Rae AP,Cobbe SM

    更新日期:1995-11-01 00:00:00

  • A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals.

    abstract:AIMS:The guidelines of the European Society of Cardiology (ESC) define the current standard for the management of syncope, but are still incompletely applied in the clinical setting. METHODS AND RESULTS:Prospective systematic evaluation, on strict adherence to the guidelines, of consecutive patients referred for synco...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehi647

    authors: Brignole M,Menozzi C,Bartoletti A,Giada F,Lagi A,Ungar A,Ponassi I,Mussi C,Maggi R,Re G,Furlan R,Rovelli G,Ponzi P,Scivales A

    更新日期:2006-01-01 00:00:00

  • Head to head comparison of dobutamine-transoesophageal echocardiography and dobutamine-magnetic resonance imaging for the prediction of left ventricular functional recovery in patients with chronic coronary artery disease.

    abstract:AIMS:A substantial number of patients with dysfunctional but potentially viable myocardium cannot be accurately evaluated by transthoracic echocardiography due to a poor acoustic window. This study compares the diagnostic value of alternative functional imaging techniques, such as dobutamine-transoesophageal echocardio...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1053/euhj.2000.1946

    authors: Baer FM,Theissen P,Crnac J,Schmidt M,Deutsch HJ,Sechtem U,Schicha H,Erdmann E

    更新日期:2000-06-01 00:00:00