Publications by authors named "Gladys N Janssens"
Article Synopsis
- In out-of-hospital cardiac arrest (OHCA) cases without ST-elevation, researchers investigated the usefulness of troponin-T (cTnT) levels in predicting the risk of acute coronary syndrome and patient survival.
- The study analyzed data from 352 patients, revealing that higher cTnT values were independent predictors for 90-day mortality and the presence of acute unstable lesions and thrombotic occlusions.
- However, cTnT levels did not show a significant correlation with left ventricular function, highlighting its role primarily in assessing mortality risk and acute coronary issues in these patients.
Impact of symptom-to-reperfusion-time on transmural infarct extent and left ventricular strain in patients with ST-segment elevation myocardial infarction: a 3D view on the wavefront phenomenon.
Eur Heart J Cardiovasc Imaging
February 2024
Article Synopsis
- The study explored how the timing of treatment (symptom-to-reperfusion time) affects heart damage in patients with ST-segment elevation myocardial infarction (STEMI) after undergoing primary percutaneous coronary intervention (PPCI).
- Researchers divided 108 STEMI patients into two groups based on their reperfusion time and found that shorter reperfusion times were linked to less heart damage (smaller infarct size) and better heart function measured by cardiovascular magnetic resonance (CMR).
- The findings suggest that a quicker treatment response correlates with better recovery of heart muscle function, particularly in circumferential and radial strain measurements, which are important for assessing heart health after an infarction.
The Dynamic Relationship Between Invasive Microvascular Function and Microvascular Injury Indicators, and Their Association With Left Ventricular Function and Infarct Size at 1-Month After Reperfused ST-Segment-Elevation Myocardial Infarction.
Circ Cardiovasc Interv
November 2022
Background: The invasive microvascular function indices, coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR), exhibit a dynamic pattern after ST-segment-elevation myocardial infarction. The effects of microvascular injury on the evolution of the microvascular function and the prognostic significance of the evolution of microvascular function are unknown. We investigated the relationship between the temporal changes of CFR and IMR, and cardiovascular magnetic resonance-derived microvascular injury characteristics in reperfused ST-segment-elevation myocardial infarction patients, and their association with 1-month left ventricular ejection fraction and infarct size (IS).
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- The study aimed to evaluate the prognostic value of ischaemic ECG patterns, specifically ST-depression and T-wave inversion, in patients who experienced out-of-hospital cardiac arrest.
- Analysis of data from 510 patients revealed that 66.7% had ischaemic ECG patterns, which were linked to a significantly lower 90-day survival rate compared to those without such patterns.
- While ischaemic ECG patterns correlated with worse survival and poorer heart function, these associations disappeared after adjusting for age and time to restore blood circulation.
Article Synopsis
- A study comparing immediate versus delayed coronary angiography in patients with out-of-hospital cardiac arrest showed no significant difference in overall mean costs between the two strategies during the initial hospital stay.
- Although immediate angiography resulted in higher procedural costs, expenses related to intensive care and ward stays were similar in both groups.
- The findings suggest that a delayed approach, allowing for neurological recovery before invasive procedures, may be a more cost-effective strategy.
Article Synopsis
- The study aims to determine if early coronary angiography (within 2 hours) after out-of-hospital cardiac arrest (OHCA) leads to a higher incidence of acute kidney injury (AKI) compared to delayed angiography.
- It analyzed data from 2,375 patients and found that 18.5% of those undergoing early angiography developed AKI versus 24.1% in the delayed group, suggesting that early angiography may not increase AKI risk (non-inferior results).
- Factors influencing AKI development included the timing of return of spontaneous circulation and use of certain heart medications, highlighting the importance of patient treatment history in AKI risk assessment.
Objectives: The optimal targeted temperature in patients with shockable rhythm is unclear, and current guidelines recommend targeted temperature management with a correspondingly wide range between 32°C and 36°C. Our aim was to study survival and neurologic outcome associated with targeted temperature management strategy in postarrest patients with initial shockable rhythm.
Design: Observational substudy of the Coronary Angiography after Cardiac Arrest without ST-segment Elevation trial.
Aims: This study aims to explore cardiovascular magnetic resonance (CMR)-derived left ventricular (LV) function, strain, and infarct size characteristics in patients with transient ST-segment elevation myocardial infarction (TSTEMI) compared to patients with ST-segment and non-ST-segment elevation myocardial infarctions (STEMI and NSTEMI, respectively).
Methods And Results: In total, 407 patients were enrolled in this multicentre observational prospective cohort study. All patients underwent CMR examination 2-8 days after the index event.
Article Synopsis
- Up to 24% of patients with ST-elevation myocardial infarction (STEMI) experience spontaneous resolution of symptoms before treatment, but the reasons for this are not well understood.
- In a study comparing 251 patients with transient STEMI and persistent STEMI, those with transient STEMI had fewer thrombus issues and a smaller infarct size, indicating less heart damage.
- The findings suggest that effective fibrinolysis (clot breakdown) in transient STEMI patients leads to lower myocardial injury and could inform better treatment strategies for STEMI in the future.
Article Synopsis
- A study was conducted on 552 patients who were resuscitated after cardiac arrest without STEMI, comparing immediate versus delayed coronary angiography and its impact on heart function.
- Results showed no significant improvement in left ventricular function, with ejection fractions of 45.2% and 48.4% for immediate and delayed groups, respectively.
- The conclusion indicates that immediate coronary angiography does not enhance heart dimensions or function compared to delaying the procedure after neurological recovery.
Sex differences in out-of-hospital cardiac arrest (OHCA) patients are increasingly recognized. Although it has been found that post-resuscitated women are less likely to have significant coronary artery disease (CAD) than men, data on follow-up in these patients are limited. Data for this data in brief article was obtained as a part of the randomized controlled Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) trial.
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- The study investigates whether sex influences survival rates in patients who experience out-of-hospital cardiac arrest (OHCA) without ST-segment elevation myocardial infarction (STEMI).
- Overall one-year survival rates were similar for men (63.4%) and women (59.6%), with no significant sex differences found.
- Women had a lower occurrence of significant coronary artery disease (CAD), but when CAD was present, their survival was worse compared to women without CAD, while men did not show this discrepancy; immediate coronary angiography did not improve survival for either sex.
Importance: Ischemic heart disease is a common cause of cardiac arrest. However, randomized data on long-term clinical outcomes of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients successfully resuscitated from cardiac arrest in the absence of ST segment elevation myocardial infarction (STEMI) are lacking.
Objective: To determine whether immediate coronary angiography improves clinical outcomes at 1 year in patients after cardiac arrest without signs of STEMI, compared with a delayed coronary angiography strategy.
Background Off-target properties of ticagrelor might reduce microvascular injury and improve clinical outcome in patients with ST-segment-elevation myocardial infarction. The REDUCE-MVI (Evaluation of Microvascular Injury in Revascularized Patients with ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel) trial reported no benefit of ticagrelor regarding microvascular function at 1 month. We now present the follow-up data up to 1.
View Article and Find Full Text PDFObjectives: This study sought to determine the agreement between cardiac magnetic resonance (CMR) imaging and invasive measurements of fractional flow reserve (FFR) in the evaluation of nonculprit lesions after ST-segment elevation myocardial infarction (STEMI). In addition, we investigated whether fully quantitative analysis of myocardial perfusion is superior to semiquantitative and visual analysis.
Background: The agreement between CMR and FFR in the evaluation of nonculprit lesions in patients with STEMI with multivessel disease is unknown.
Article Synopsis
- - The study aimed to compare the effects of delayed versus immediate invasive treatment on heart damage and patient outcomes in individuals with transient ST-segment elevation myocardial infarction (STEMI).
- - Researchers randomly assigned 142 patients to receive either delayed (22.7 hours) or immediate (0.4 hours) cardiac intervention and evaluated heart function and infarct size using imaging techniques at 4-day and 4-month follow-ups.
- - Results showed no significant differences in heart damage, function, or major health events between the two treatment groups, indicating that timing of intervention may not impact outcomes in transient STEMI cases.
Importance: Percutaneous coronary intervention (PCI) of nonculprit vessels among patients with ST-segment elevation myocardial infarction (STEMI) is associated with improved clinical outcome compared with culprit vessel-only PCI. Fractional flow reserve (FFR) and coronary flow reserve are hyperemic indices used to guide revascularization. Recently, instantaneous wave-free ratio was introduced as a nonhyperemic alternative to FFR.
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- * In a multicenter trial, 552 patients without STEMI were randomly assigned to receive immediate or delayed coronary angiography, with survival rates at 90 days as the primary focus.
- * Results showed no significant difference in survival rates between the immediate angiography (64.5% alive) and delayed angiography (67.2% alive) groups after 90 days, suggesting that immediate intervention may not offer a survival advantage in these cases.
Background: Despite successful restoration of epicardial vessel patency with primary percutaneous coronary intervention, coronary microvascular injury occurs in a large proportion of patients with ST-segment-elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reported to increase plasma adenosine levels, which might have a protective effect on the microcirculation. We investigated whether ticagrelor maintenance therapy after revascularized ST-segment-elevation myocardial infarction is associated with less coronary microvascular injury compared to prasugrel maintenance therapy.
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- - The study focuses on patients with transient ST-segment elevation myocardial infarction (STEMI), who initially show ST-elevation on ECG but then experience symptom relief before treatment; the goal is to assess whether immediate or delayed invasive treatment is better for these cases.
- - In a trial involving 142 patients, researchers compared immediate and delayed treatment strategies and found little difference in infarct size and short-term adverse events like death or reinfarction between the two groups.
- - Conclusions indicate that the infarct size remains small regardless of treatment timing, and both immediate and delayed strategies result in similar rates of major adverse cardiac events within 30 days.
Background: Mild therapeutic hypothermia (32-36 °C) is associated with improved outcomes in patients with brain injury after cardiac arrest (CA). Various devices are available to induce and maintain hypothermia, but few studies have compared the performance of these devices. We performed a prospective study to compare four frequently used cooling systems in inducing and maintaining hypothermia followed by controlled rewarming.
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