Publications by authors named "Christos Kotanidis"
Aims: Women and older patients are underrepresented in randomized controlled trials (RCTs) investigating treatment strategies following acute coronary syndrome. This study aims to evaluate the benefit of invasive vs. conservative strategy of older women with non-ST-elevation acute coronary syndrome (NSTEACS).
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- A 43-year-old woman developed both UVF and VVF after a total hysterectomy and initially tried conservative treatment, which didn't work.
- She then underwent a successful surgical procedure to correct the issues and has remained symptom-free for a year, highlighting the importance of recognizing and managing these rare fistula formations effectively.
Article Synopsis
- - Ischaemic heart disease (IHD) has mainly been linked to obstructive coronary artery disease (CAD), but over 50% of patients have non-obstructive coronary arteries, leading to interest in angina due to these non-obstructive conditions (ANOCA/INOCA).
- - INOCA includes various causes like coronary microvascular dysfunction (CMD) and vasospastic angina, with CMD resulting from poor vasodilatory capacity of small blood vessels; it is particularly more common in women and linked to worse heart health outcomes.
- - Research has improved the understanding and classification of these conditions, including the use of advanced imaging and testing methods to better diagnose CMD and inform treatment strategies for affected patients. *
Article Synopsis
- Older patients with non-ST-elevation acute coronary syndrome (NSTEACS) often receive less adequate care, prompting a meta-analysis to compare routine invasive versus conservative treatment strategies based on individual patient data from recent trials.
- The study analyzed data from six randomized controlled trials involving 1,479 older adults, focusing on the impact of treatment type on all-cause mortality and myocardial infarction at one year.
- Results indicated no significant difference in mortality rates between the two treatment groups, but routine invasive management showed a lower risk of myocardial infarction and a greater likelihood of urgent revascularization.
Article Synopsis
- Visceral obesity increases cardiovascular risk, including heart failure, prompting a study on the role of microRNAs (miRNAs) from epicardial adipose tissue (EAT) in regulating heart function and outcomes.
- Researchers identified that EAT miR-92a-3p lowers oxidative stress in the heart and is linked to reduced cardiovascular events, showing its role in the heart's redox state via a specific biological pathway.
- The study suggests that EAT-derived miR-92a-3p could be a promising therapeutic target for preventing and treating heart disease associated with obesity.
Article Synopsis
- The study aimed to create a deep-learning network for automatically measuring epicardial adipose tissue (EAT) volume using coronary computed tomography angiograms (CCTA), which indicates visceral obesity.
- It involved training the model on 3,720 CCTA scans and testing its effectiveness in difficult cases and in a patient cohort after cardiac surgery.
- Results showed a strong correlation with human measurements, and higher EAT volumes were linked to increased risks of coronary artery disease, atrial fibrillation, and various cardiovascular events, indicating its potential prognostic value in clinical settings.
Surgical treatment of endometrioid endometrial carcinoma - laparotomy versus laparoscopy.
J Turk Ger Gynecol Assoc
December 2022
Article Synopsis
- Recent studies questioned the safety of laparoscopic surgery for endometrial cancer, prompting this research to compare laparoscopic and laparotomy methods in terms of cancer outcomes and surgical effectiveness.
- A retrospective analysis of 151 patients showed that laparoscopy had significantly lower blood loss, shorter hospital stays, and fewer complications compared to laparotomy, while recurrence-free and overall survival rates were similar between the two groups.
- The conclusion suggests that although oncological outcomes were comparable, laparoscopy offered better surgical results, highlighting the need for clinical trials to further investigate its efficacy for endometrial cancer treatment.
Article Synopsis
- Scientists are trying to find a better way to measure inflammation in blood vessels of COVID-19 patients to help figure out who might have serious issues later and who might benefit from treatments.
- They created a new system using artificial intelligence that looks at images from CT scans to help identify this inflammation, called C19-RS.
- Their study showed that COVID-19 patients had higher levels of this C19-RS, and those with certain virus variants were even more likely to have serious complications, helping doctors predict who might not survive their hospital stay.
Article Synopsis
- * It reveals that while morcellation doesn't significantly affect overall survival rates compared to non-morcellation, certain preoperative characteristics like tumor size and vascularization can indicate a higher risk of sarcoma.
- * The findings suggest that morcellation may increase the risk of recurrence for abdominal and pelvic tumors, emphasizing the need for better preoperative assessment to differentiate between sarcoma and other conditions like uterine myoma.
Article Synopsis
- The study investigated the impact of lymphadenectomy on morbidity and mortality in patients with endometrial cancer who underwent surgery, highlighting the potential complications associated with this procedure.
- Data from 232 patients were analyzed, revealing that those who had lymphadenectomy experienced significantly more postoperative complications, such as the need for revision surgery due to lymphoceles.
- Despite the increased complications, the study found no significant difference in survival rates between patients who had lymphadenectomy and those who did not, suggesting a need for improved risk assessment before surgery.
Article Synopsis
- Advances in medical imaging technology, especially computed tomography (CT), have transformed the assessment of cardiovascular diseases, making CT a primary tool for evaluating both stable and unstable conditions.
- Vascular inflammation plays a significant role in atherosclerosis, affecting the surrounding perivascular adipose tissue (PVAT), which is involved in various biological processes through its secreted substances.
- This review focuses on the use of cardiac CT to visualize vascular inflammation by examining the characteristics and effects of PVAT.
Article Synopsis
- This study examines how canagliflozin, an SGLT2 inhibitor, impacts heart function and potentially improves cardiovascular outcomes for heart failure patients through effects on redox signaling.!
- Researchers conducted multiple studies, involving patient biopsies and cell cultures, to see how this drug influences oxidative stress and inflammation in heart tissue, finding that it reduces harmful enzyme activity while enhancing protective mechanisms.!
- The results suggest that canagliflozin operates through SGLT1/AMPK/Rac1 signaling, leading to reduced inflammation and cell death in heart muscle cells, uncovering a new mechanism behind its positive cardiac effects.!
Article Synopsis
- A study was conducted on 72 patients with idiopathic ventricular arrhythmias (VAs) who showed no structural heart issues through standard tests.
- Cardiac magnetic resonance (CMR) imaging revealed additional abnormalities in over half of the patients, with past myocarditis being the most common diagnosis.
- Factors like being male, older age, and having specific types of premature ventricular contractions (PVCs) were associated with abnormal CMR findings, indicating they may be useful indicators for further testing.
Article Synopsis
- Obesity increases cardiovascular risk, and this study investigates how dysregulation in the metabolome of adipose tissue may impact vascular health and outcomes.
- Researchers examined metabolites secreted by thoracic and subcutaneous adipose tissue in obese patients, linking these to oxidative stress and inflammation in individuals undergoing coronary bypass surgery.
- Findings revealed that certain sphingolipids, particularly C16:0-ceramide, are associated with reduced nitric oxide availability and increased oxidative stress, linking high plasma levels of these metabolites to a greater risk of cardiac mortality.
Article Synopsis
- - The study investigates the link between ABO blood groups and the occurrence/severity of endometrial cancer in patients who had surgery between 2006 and 2018, analyzing various clinical factors like cancer grade and stage using statistical tests.
- - Out of 202 patients, blood group distribution was in line with Germany's general population, but no significant associations were found between blood type (A, B, O, AB) and cancer characteristics such as grade, stage, or recurrence.
- - Consequently, the research concludes that blood group screening is unlikely to aid in diagnosing early endometrial cancer or predict cancer recurrence, similar to existing diagnostic methods.
Article Synopsis
- * In a study of 1004 patients with atherosclerosis, obese individuals showed higher levels of WNT5A in the blood and adipose tissue, increased expression of its receptors in artery walls, and greater oxidative stress, which relates to heart disease progression.
- * The research suggests that WNT5A promotes oxidative stress and migration of smooth muscle cells in arteries through a novel signaling pathway, highlighting its role in connecting obesity and vascular disease, with potential implications for treatment in humans.
Article Synopsis
- Coronary inflammation affects the water and lipid balance in perivascular adipose tissue (PVAT), and combining this with additional fibrotic and microvascular changes may enhance cardiac risk prediction.
- A new AI method analyzes the radiomic profile of coronary PVAT, using data from three studies to link gene expression with CT imaging features related to inflammation and fibrosis.
- In a large cohort of patients, the developed fat radiomic profile (FRP) successfully predicted major adverse cardiac events (MACE) better than traditional risk factors, improving risk stratification significantly.
Article Synopsis
- Perivascular adipose tissue (PVAT) around coronary arteries secretes adipocytokines that influence nearby vascular biology, but it can also sense and respond to signals from the vascular wall, especially during inflammation.
- Vascular inflammation causes changes in PVAT, shifting its composition and resulting in increased computed tomography (CT) attenuation, which can be used to detect coronary artery inflammation non-invasively.
- A new biomarker called the Fat Attenuation Index (FAI) captures these changes and shows promise for predicting cardiac events, potentially transforming the interpretation of cardiovascular CT angiography by providing insights into the inflammatory status of the coronary arteries.
Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data.
Evangelos K Oikonomou Mohamed Marwan Milind Y Desai Jennifer Mancio Alaa Alashi Christos P Kotanidis
Lancet
September 2018
Article Synopsis
- Coronary artery inflammation affects the surrounding fat tissue and a new imaging biomarker, the perivascular fat attenuation index (FAI), helps visualize this inflammation using coronary CT scans.
- A study analyzed data from two groups of patients in Germany and the U.S. to determine whether the perivascular FAI can predict clinical outcomes like death.
- Results from both patient groups showed that higher FAI values around specific coronary arteries (especially the right coronary artery and left anterior descending artery) were linked to higher rates of all-cause and heart-related mortality.