Prevalence and Impact of Atrial Fibrillation on Intra-Hospital Mortality in Patients Aged ≥75 Years.

It is unclear whether the association between atrial fibrillation (AF) and intra-hospital mortality in patients aged 75 years and older is causal or not. This study aims (1) to describe the prevalence and clinical characteristics of AF in ≥75-year-old inpatients and (2) to study the association between AF and length of stay (LOS) and intra-hospital mortality. This retrospective cohort study includes consecutive patients aged ≥75 years admitted between January 2017 and December 2019 to a Belgian secondary hospital.

Association between atrial fibrillation, frailty, and geriatric syndromes in the late elderly in a south Belgian outpatient and inpatient setting.

Study Objective: This study aims to analyze the relationship between AF, frailty, and geriatric syndromes in elderly patients in an outpatient and inpatient setting in a South Belgian hospital.

Participants Design And Setting: This is a single center case-control retrospective study including 207 patients enrolled from an outpatient and inpatient setting of the Department of Geriatrics, Jolimont Hospital Group. Frailty was assessed using a complete geriatric assessment and Rockwoods Clinical Frailty Scale.

Dobutamine stress echocardiography in patients with moderate coronary artery disease detected by coronary computed tomography angiography could reduce the rate of unnecessary coronary angiography.

Aims: To test the hypothesis that dobutamine stress echocardiography (DSE) reduces the rate of unnecessary invasive coronary angiography (CA) in patients with chronic stable coronary artery disease (CAD) and moderate to severe stenosis detected by coronary computed tomography angiography (CCTA).

Methods: This study included 49 consecutive, symptomatic CAD patients with coronary lesions greater than 50% detected by CCTA who underwent all DSE and a CA with pressure wire evaluation and FFR measurement. The DSE operators was aware of the CCTA results, but invasive physicians were blinded to DSE results.

Feasibility and Safety of Performing Complex Coronary Interventions by Distal Radial Artery Using the Railway Sheathless Vascular System.

Aims: The aim of this clinical study is to assess the feasibility and safety of the 7 Fr Railway sheathless access system (Cordis Corporation) for complex percutaneous coronary interventions (PCI) using distal radial artery access.

Methods And Results: Over a 2-month period, we enrolled 20 patients (all those undergoing complex PCI) where a 7 Fr guide catheter was deemed necessary. Multiple bifurcation techniques and calcified plaque modifying tools were used.

A Belgian consensus strategy to identify familial hypercholesterolaemia in the coronary care unit and its subsequent cascade screening and treatment: BEL-FaHST (The BELgium Familial Hypercholesterolaemia STrategy).

Background And Aims: Familial hypercholesterolaemia (FH) is an autosomal dominant lipoprotein disorder characterized by significant elevation of low-density lipoprotein cholesterol (LDL-C) and markedly increased risk of premature cardiovascular disease (CVD). Because of the very high coronary artery disease risk associated with this condition, the prevalence of FH among patients admitted for CVD outmatches many times the prevalence in the general population. Awareness of this disease is crucial for recognizing FH in the aftermath of a hospitalization of a patient with CVD, and also represents a unique opportunity to identify relatives of the index patient, who are unaware they have FH.

One-year and longer dual antiplatelet therapy after an acute coronary syndrome: a Belgian position paper.

Acute coronary syndrome patients receive DAPT up to one year after their initial event. Exceptions to the guideline-recommended one-year rule, however, are not uncommon. The reasoning behind shorter treatments, such as unacceptable bleeding risk or urgent surgery, should be well documented in the patient's charts and discharge letter.

Alternans of the Ventricular Electrogram in Patients with an Implanted Cardioverter-Defibrillator.

Background: The occurrence and significance of alternans of the ventricular electrogram (VEGM) in patients with an implanted cardioverter-defibrillator (ICD) has been rarely reported.

Objectives And Methods: This report describes our observations of VEGM alternans documented in nine patients with an ICD (seven new cases and two previously published cases for comparison).

Results: We found seven new cases of near-field VEGM alternans and added two of our previously reported examples.

Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry.

Aims: The relationship between the predictive performance of the TIMI risk score for STEMI and gender has not been evaluated in the setting of primary PCI (pPCI). Here, we compared in-hospital mortality and predictive performance of the TIMI risk score between Belgian women and men undergoing pPCI.

Methods And Results: In-hospital mortality was analysed in 8,073 (1,920 [23.

Reperfusion therapy and mortality in octogenarian STEMI patients: results from the Belgian STEMI registry.

Background: Treatment strategies and outcome of ST-elevation myocardial infarction (STEMI) have been mainly studied in middle-aged patients. With increasing lifetime expectancy, the proportion of octogenarians will substantially increase. We aimed to evaluate whether the benefit of currently recommended reperfusion strategies is maintained in octogenarians.

STEMI mortality in community hospitals versus PCI-capable hospitals: results from a nationwide STEMI network programme.

Aims: Reports examining local ST elevation myocardial infarction (STEMI) networks focused mainly on percutaneous coronary intervention (PCI)-related time issues and outcomes. To validate the concept of STEMI networks in a real-world context, more data are needed on management and outcome of an unselected community based STEMI population.

Methods And Results: The current study evaluated reperfusion strategies and in-hospital mortality in 8500 unselected STEMI patients admitted to 47 community hospitals (n=3053) and 25 PCI-capable hospitals (n=5447) in the context of a nationwide STEMI network programme that started in 2007 in Belgium.

Contemporary mortality differences between primary percutaneous coronary intervention and thrombolysis in ST-segment elevation myocardial infarction.

Background: Current ST-segment elevation myocardial infarction guidelines regarding reperfusion strategy are based on trials conducted before the application of routine invasive evaluation after thrombolysis. Modern thrombolysis may affect the previously observed mortality difference between primary percutaneous coronary intervention (PPCI) and thrombolysis.

Methods: In-hospital mortality was prospectively assessed in 5295 patients with ST-segment elevation myocardial infarction admitted to 73 Belgian hospitals from July 1, 2007, through December 31, 2009.

TIMI risk score underestimates prognosis in unstable angina/non-ST segment elevation myocardial infarction.

Objectives: To determine the value of the TIMI risk score in the individual risk stratification of patients with unstable angina/non-ST segment elevation myocardial infarction (UA/NSTEMI).

Background: TIMI risk score is a validated tool to identify groups of patients at high risk for major cardiac events. Its prognostic value in individual patients with current diagnostic tools and therapy is unknown.

Short-term effect of atorvastatin on ischaemic threshold in hypercholesterolaemic patients with stable ischaemic heart disease.

Objective: Hypercholesterolaemia is associated with a loss of endothelium-dependent vasodilation, which may facilitate the occurrence of myocardial ischaemia in patients with coronary artery disease (CAD). The improvement of endothelial dilator function after 4 to 6 weeks of oral lipid-lowering therapy has been documented. Whether this early restoration of endothelial function by statins translates into anti-ischaemic effects is unknown.

Silent ischaemia in familial hypercholesterolemia.

In a cohort of 66 FH-men (age 25-55) prospectively recruited during a 2-years period, we estimated the incidence of coronary heart disease to 52% (N=34). Thirty-two percent (N=21) had earlier history of symptomatic ischaemic disease whereas 20% (N=13) had significant ST/T changes during exercise stress test. Amongst the 8 patients with positive exercise stress test who underwent coronary angiography, six had severe coronary artery disease.

Myocardial infarction and primary thrombocytosis in a young man.

We report the case of a 27-year-old male smoker with simultaneous myocardial infarction (MI) and acute peripheral ischaemia. At the time of his first hospitalization, the platelet count and the coronary angiogram were normal. Two years later, the patient presented again with a leg artery occlusion, followed, a few days later, by a recurrence of MI.

Comparative fibrinolytic activity of front-loaded alteplase and the single-bolus mutants tenecteplase and lanoteplase during treatment of acute myocardial infarction.

Background: Quantification of fibrinolytic activity (FAct) in clinical practice has been abandoned because of the complexity of existing assays. The relationship between thrombolytic drug concentration and FAct is complex. FAct profiles of currently used thrombolytic drugs were not characterized.