Publications by authors named "Michiel Bots"
Background: High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality.
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- The study evaluated the PACAS risk model's ability to identify patients at high risk for severe asymptomatic carotid artery stenosis (ACAS) and predict future strokes and cardiovascular disease (CVD) risk.
- It involved 26,384 patients aged 45-80, finding that 6.3% had severe ACAS at baseline and that higher PACAS scores correlated with increased incidences of stroke and CVD over roughly 70,000 patient-years of follow-up.
- The PACAS model was confirmed to effectively discriminate and calibrate risk levels, indicating that patients with higher scores had a significantly higher prevalence of severe ACAS and related events during the follow-up period.
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- The study investigates how well clinicians accept real-time data imputation to address missing patient data in a clinical decision support system (CDSS) designed for assessing cardiovascular risk.
- Seventeen clinicians evaluated a CDSS using a method called joint modelling imputation (JMI), assessing vignettes that simulated situations with missing data and provided different risk estimates.
- Although the study found JMI useful for educational purposes, clinicians felt uncomfortable with the reliability of imputed predictions, indicating a need for more accurate data imputation for effective use in clinical practice.
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- Genome-wide association studies have found numerous genetic loci linked to glycemic traits, but connecting these loci to specific genes and biological pathways remains a challenge.
- Researchers conducted meta-analyses of exome-array studies across four glycemic traits, analyzing data from over 144,000 participants, which led to the identification of coding variant associations in more than 60 genes.
- The study revealed significant pathways related to insulin secretion, zinc transport, and fatty acid metabolism, enhancing understanding of glycemic regulation and making data available for further research.
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- - The study examines the relationship between kidney function and echocardiography findings related to left ventricular diastolic dysfunction (LVDD) in patients from a university hospital, categorizing them by levels of kidney function based on estimated glomerular filtration rate (eGFR).
- - Among 4,022 patients, those with increasingly decreased kidney function showed higher odds of having abnormal echocardiographic parameters, including the E/e' ratio and left ventricular mass index (LVMI), indicating a clear connection between deteriorating kidney health and worsening cardiac function.
- - The findings reveal that even mildly decreased kidney function is associated with signs of LVDD, suggesting that as kidney function declines, the risk of echocardiographic abnormalities in
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- Frequent hemodialysis (more than three times a week) may lower mortality and improve quality of life for kidney failure patients, but the evidence is not clear.
- A systematic review of available studies found only seven eligible trials with a total of 518 participants, indicating limited data on the health effects of frequent hemodialysis.
- The analysis suggested a possibly lower risk of death with frequent hemodialysis, but results were uncertain, and important outcomes like cardiovascular events and patient-reported well-being were largely missing.
Background: Treatment targets for cardiovascular risk management make no distinction between women and men.
Aim: To explore sex differences in achieving treatment targets in patients that participated in a nurse-led, integrated CVRM care programme in primary care between 2013 and 2019.
Design & Setting: We conducted a dynamic cohort study in the Eindhoven region, south-east of The Netherlands METHOD: We assessed outcomes of three biological risk factors (systolic blood pressure, low density lipoprotein-cholesterol and estimated glomerular filtration rate) and four lifestyle factors (smoking, physical activity, alcohol intake and body mass index).
Purpose: We applied a previously established common T-score metric for patient-reported and performance-based physical function (PF), offering the unique opportunity to directly compare measurement type-specific patterns of associations with potential laboratory-based, psychosocial, sociodemographic, and health-related determinants in hemodialysis patients.
Methods: We analyzed baseline data from the CONVINCE trial (N = 1,360), a multinational randomized controlled trial comparing high-flux hemodialysis with high-dose hemodiafiltration. To explore the associations of potential determinants with performance-based versus patient-reported PF, we conducted multiple linear regression (backward elimination with cross-validation and Lasso regression).
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- A long-term study evaluated the outcomes of different heart procedures: on-pump CABG, off-pump CABG, and PCI over a 20-year period, using data from trials conducted between 1998 and 2000.
- Findings showed no significant differences in overall mortality rates between on-pump and off-pump CABG or PCI and off-pump CABG.
- However, off-pump CABG patients had fewer re-intervention procedures compared to those who underwent PCI.
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- * Researchers also assessed health-related quality of life (HRQoL) across various domains, finding that while both groups experienced a decline, the HDF group showed more favorable changes, particularly in cognitive function.
- * Overall, the trial indicated HDF not only benefits survival rates but also helps slow the decline in quality of life aspects for patients, particularly in physical and cognitive functioning.
Background: Electronic informed consent (eIC) is increasingly used in clinical research due to several benefits including increased enrollment and improved efficiency. Within a learning health care system, a pilot was conducted with an eIC for linking data from electronic health records with national registries, general practitioners, and other hospitals.
Objective: We evaluated the eIC pilot by comparing the response to the eIC with the former traditional paper-based informed consent (IC).
Background: Clinical decision support systems (CDSSs) based on routine care data, using artificial intelligence (AI), are increasingly being developed. Previous studies focused largely on the technical aspects of using AI, but the acceptability of these technologies by patients remains unclear.
Objective: We aimed to investigate whether patient-physician trust is affected when medical decision-making is supported by a CDSS.
Objective: Predicting adverse outcomes in patients with peripheral arterial disease (PAD) is a complex task owing to the heterogeneity in patient and disease characteristics. This systematic review aimed to identify prognostic factors and prognostic models to predict mortality outcomes in patients with PAD Fontaine stage I - III or Rutherford category 0 - 4.
Data Sources: PubMed, Embase, and Cochrane Database of Systematic Reviews were searched to identify studies examining individual prognostic factors or studies aiming to develop or validate a prognostic model for mortality outcomes in patients with PAD.
Background: Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Given their high prevalence, it is important to understand the disease burden of cancer mortality in CVD patients.
Objective: We aimed to evaluate whether patients with incident CVD have a higher risk of malignancy-related mortality, compared to the general population without CVD.
Key Points: The prevalence of polypharmacy in patients with CKD was over 80%. Polypharmacy was highest in patients with a kidney transplant and those receiving dialysis. Polypharmacy is associated with worse clinical outcomes, lower quality of life, and medication-related problems in patients with CKD.
View Article and Find Full Text PDFRationale and design for the randomized placebo-controlled double-blind trial studying the effect of single antiplatelet therapy (clopidogrel) versus dual antiplatelet therapy (clopidogrel/acetylsalicylic acid) on the occurrence of atherothrombotic events following lower extremity peripheral transluminal angioplasty (CLEAR-PATH).
Am Heart J
July 2024
Rationale: Antiplatelet therapy (APT) is the standard of care after endovascular revascularization (EVR) in patients with peripheral artery disease (PAD). APT aims to prevent both major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nonetheless, the rates of MACE and MALE after EVR remain high.
View Article and Find Full Text PDFBackground: Despite programmatic protocolised care and structured support, considerable variation is observed in completeness of registration and achieving targets of cardiovascular risk management (CVRM) between individual GPs in the Netherlands.
Aim: To determine whether completeness of registration and achieved targets of cardiovascular risk factors improves with practice visitation.
Design & Setting: Observational study utilising the care group's database (2016-2019), comparing changes in registration and achieved targets in non-visited practices and visited practices.
Importance: Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease, but their systematic underrepresentation in cardiovascular randomized clinical trials (RCTs) limits the generation of appropriate evidence to guide cardiovascular risk management (CVRM).
Objective: To evaluate the underrepresentation of patients with CKD in cardiovascular RCTs, and to highlight evidence gaps in CVRM medications in this population.
Evidence Review: A systematic search was conducted in ClinicalTrials.
Background: Since 2010, an increasing number of patients have participated in a nurse-led integrated cardiovascular risk management programme in the Netherlands. Because it is important to understand which patients discontinue and why, when evaluating the effectiveness of the care programme, the aim was to identify the reasons for discontinuation.
Methods: Electronic health records of 3997 patients enrolled in a nurse-led integrated cardiovascular risk management programme that started on April 1 2010, were manually scrutinized for reasons for discontinuation between April 1 2010, and April 1 2018.
In kidney transplantation, survival rates are still partly impaired due to the deleterious effects of donor specific HLA antibodies (DSA). However, not all luminex-defined DSA appear to be clinically relevant. Further analysis of DSA recognizing polymorphic amino acid configurations, called eplets or functional epitopes, might improve the discrimination between clinically relevant vs.
View Article and Find Full Text PDFAims: The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs).
Methods And Results: EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias.
Introduction: In the Netherlands, the prevalence of cardiovascular diseases (CVDs) is higher among South-Asian Surinamese and lower among Moroccans compared to the Dutch. Traditional risk factors for atherosclerotic CVD do not fully explain these disparities. We aimed to assess ethnic differences in plaque presence and carotid intima-media thickness (cIMT) and explore to what extent these differences are explained by traditional risk factors.
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- The study examines how kidney dysfunction correlates with left ventricular diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF), focusing on whether these associations differ between sexes.
- Data was collected from 880 participants, revealing that those with mild to moderate kidney dysfunction had significantly higher rates of HFpEF compared to those with normal kidney function, along with elevated measures of heart function.
- The findings suggest that both mild and moderate kidney dysfunction are major risk factors for HFpEF, with the strongest link found in moderate dysfunction, indicating the need for early intervention in at-risk groups.
Background: Chronic kidney disease (CKD) is a significant risk factor for cardiovascular disease (CVD) and death. Increased oxidative stress in people with CKD has been implicated as a potential causative factor. Antioxidant therapy decreases oxidative stress and may consequently reduce cardiovascular morbidity and death in people with CKD.
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