Publications by authors named "Smits P"

Objectives: This study aimed to detail the technical management of Medina 0.0.1 lesions, assess their outcomes, and identify predictors of Major Adverse Cardiovascular Events (MACE).

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Background: Abbreviated antiplatelet therapy (APT) reduces bleeding without increasing ischemic events in largely unselected high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) is associated with higher ischemic risk, and its impact on the safety and effectiveness of abbreviated APT in HBR PCI patients remains unknown.

Objectives: This study sought to investigate the comparative effectiveness of abbreviated (1 month) vs standard (≥3 months) APT in HBR patients with and without DM after biodegradable polymer sirolimus-eluting coronary stent implantation.

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  • The BIONICS and NIREUS trials compared the ridaforolimus-eluting stent (RES) and zotarolimus-eluting stent (ZES), showing that RES was noninferior to ZES for 1-year target-lesion failure and 6-month lumen loss.
  • A pooled analysis of 2221 patients over 5 years found similar rates of target-lesion failure (12.2% for RES vs 11.3% for ZES), with no significant differences in other outcomes like myocardial infarction or stent thrombosis.
  • Although the RES group had higher rates of target-vessel revascularization and cardiac death, these differences were not significant after adjusting for patient characteristics, indicating long-term
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  • The study investigates the effectiveness of a new implant called the DynamX bioadaptor compared to a traditional drug-eluting stent (DES) in improving outcomes for patients undergoing percutaneous coronary intervention (PCI) due to heart disease.
  • Conducted across 20 hospitals in Sweden, the study randomly assigned eligible patients aged 18-85 to receive either the bioadaptor or a zotarolimus-eluting DES, measuring outcomes such as target lesion failure after 12 months.
  • The primary goal is to ensure the new device is not worse than the DES by measuring specific heart-related adverse events and ensuring that the risk difference remains within a predefined limit, indicating safety and efficacy.
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  • * Patients in the trial receive either evolocumab or a placebo for 12 weeks, alongside high-intensity statin therapy, and are monitored for changes in plaque size and composition using advanced imaging techniques.
  • * This study is notable for being the first to assess how significant reductions in low-density lipoprotein cholesterol (LDL-C) could impact the health of non-critical coronary lesions shortly after treatment.
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  • - The ACC/AHA Chest Pain guidelines support the use of Coronary CT Angiography (CCTA) and FFRCT for better diagnosing coronary artery disease (CAD), yet many healthcare providers are not following these recommendations.
  • - In a study involving 673 stable chest pain patients across five European countries, CCTA emerged as the most frequently used noninvasive test, but nearly 40% of patients still received immediate CAD treatment without prior testing.
  • - The study revealed a lack of progress in improving adherence to CCTA and a low usage of FFRCT, underscoring the need for better diagnostic practices and updates to reimbursement policies.
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  • Intracoronary continuous thermodilution is a new method to measure coronary flow and microvascular resistance, but its effectiveness in patients with angina and non-obstructive coronary arteries (ANOCA) is still unclear.
  • This study involved 120 patients undergoing coronary function tests, including acetylcholine testing, to assess their coronary flow and microvascular function.
  • Results showed that a high percentage of patients had positive coronary function tests, and specific measurements (Qmax and Rμ,hyper) were linked to these positive results, suggesting that the continuous thermodilution technique could help understand different ANOCA profiles better.
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  • The study aimed to compare the safety and effectiveness of two types of stents in patients at high bleeding risk who were undergoing abbreviated dual antiplatelet therapy after coronary stenting: the ultrathin-strut Supraflex Cruz stent and the thin-strut Ultimaster Tansei stent.
  • A total of 741 patients were enrolled in a randomized trial where they received one of the two stents, and the primary outcome measured was a combination of serious adverse events over one year.
  • Results showed that 15.4% of patients with the Supraflex Cruz stent experienced adverse outcomes compared to 17.1% with the Ultimaster Tansei stent, indicating a potential slight difference
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Objective: This study aimed to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people who experience anxiety and/or depressive symptoms following acquired brain injury.

Methods: The study is a multicentre randomized controlled two-arm parallel trial. In total, 72 people who survived a stroke or traumatic brain injury were randomized into an eight-session ACT or control (i.

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  • Complete revascularization is the standard treatment for older STEMI patients with multivessel disease, offering benefits shown in the FIRE trial, though long-term effects remain uncertain.
  • A meta-analysis of several randomized clinical trials analyzed data from 1733 patients aged 75 and older, comparing complete versus culprit-only revascularization strategies.
  • Results indicated that complete revascularization significantly reduced the risk of cardiovascular death or myocardial infarction in the long term, but did not show a difference in overall death rates compared to culprit-only revascularization.
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Catalytic amounts of 1,3-di(methyl)imidazole-2-ylidene, one of the simplest and most prototypical N-heterocyclic carbenes, can up-convert aldehydes into powerful stoichiometric sources of electrons (Super Electron Donors) for reductive transformations of iodoaryls ( < -2 V). In particular, the hydroarylation of 1,1'-diarylethylenes, which may require high temperatures and inherently generate stoichiometric amounts of oxidized waste, was performed at room temperature, with the concomitant formation of esters as oxidized co-products.

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Background: Incomplete revascularization (ICR) has been associated with a worse prognosis after a percutaneous coronary intervention (PCI). In NSTEMI patients with multivessel disease (MVD) however, the benefit of a complete revascularization (CR) remains unclear.

Methods: Patients presenting with an NSTEMI and MVD were selected from the global e-ULTIMASTER registry and grouped according to completeness of revascularization at index hospitalization discharge.

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The STARlet All-In-One system is a modular platform that integrates the complete molecular diagnostic workflow from nucleic acid extraction of clinical samples to PCR set-up and amplification. The platform was evaluated in comparison with laboratory developed tests (LDT) on fecal samples from patients with suspected viral gastro-enteritis. In a retrospective study, 72 positive samples were analysed, including all pathogens detected by the Seegene Allplex™ GI-virus assay, adenovirus, astrovirus, norovirus GI and GII, sapovirus, and rotavirus.

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Background: It has been suggested that coronary microvascular function decreases with age, irrespective of the presence of epicardial atherosclerosis.

Aims: Our aim is to quantitatively investigate the effects of age on microvascular function in patients with normal coronary arteries.

Methods: In 314 patients with angina with no obstructive coronary artery disease (ANOCA), microcirculatory function was tested using the continuous thermodilution method.

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Background: There are different definitions of periprocedural myocardial infarction (PPMI) both in terms of thresholds for cardiac biomarkers and the ancillary criteria for myocardial ischemia. Cardiac Troponin I (cTnI) and cardiac Troponin T (cTnT) are used interchangeably to diagnose PPMI.

Objectives: This study evaluated the frequency of periprocedural myocardial injury and infarction as defined by the Society of Cardiovascular Angiography & Interventions (SCAI), the Academic Research Consortium-2 (ARC-2), and the 4th Universal definition of MI (4UDMI) stratified using cTnT versus cTnI, among patients with chronic coronary syndrome (CCS) and unstable angina.

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Introduction: Despite the growing awareness towards the importance of adequate representation of women in clinical trials among patients treated with percutaneous coronary intervention (PCI), available evidence continues to demonstrate a skewed distribution of study populations in favour of men.

Methods And Results: In this pre-specified analysis from the MASTER DAPT screening log and trial, we aimed to investigate the existence of a negative selection bias for women inclusion in a randomized clinical trial. A total of 2847 consecutive patients who underwent coronary revascularization across 65 participating sites, during a median of 14 days, were entered in the screening log, including 1749 (61.

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  • The study aimed to evaluate the prevalence of high bleeding risk (HBR) characteristics in patients who underwent percutaneous coronary intervention (PCI) and assess the representativeness of the MASTER DAPT trial data.
  • Out of 2,847 patients screened, 38.6% were identified as HBR, but only 9.9% consented to participate in the trial, revealing differences in HBR characteristics between consenting and non-consenting patients.
  • The findings highlight significant selection biases, as the characteristics of HBR patients in the trial differed notably from those in the overall patient population, indicating that trial results may not fully reflect real-world scenarios.
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As the discovery of cryptic species has increased in frequency, there has been an interest in whether geometric morphometric data can detect fine-scale patterns of variation that can be used to morphologically diagnose such species. We used a combination of geometric morphometric data and an ensemble of five supervised machine learning methods (MLMs) to investigate whether plastron shape can differentiate two putative cryptic turtle species, and has been the focus of considerable research due to its biogeographic distribution and conservation status. Despite this work, reliable morphological diagnoses for its two species are still lacking.

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This study compared the effect of two frequencies of direct cold atmospheric plasma (direct-CAP) treatment with standard of care (SOC) alone on healing of venous leg ulcers (VLUs). Open-label, randomized controlled trial (ClinicalTrials.gov NCT04922463) on chronic VLUs at two home care organizations in the Netherlands.

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Objective: Focal cortical dysplasias (FCD) are characterized by distinct interictal spike patterns and high frequency oscillations (HFOs; ripples: 80-250 Hz; fast ripples: 250-500 Hz) in the intra-operative electrocorticogram (ioECoG). We studied the temporal relation between intra-operative spikes and HFOs and their relation to resected tissue in people with FCD with a favorable outcome.

Methods: We included patients who underwent ioECoG-tailored epilepsy surgery with pathology confirmed FCD and long-term Engel 1A outcome.

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  • This study investigates whether crushed prasugrel loading doses administered before hospital arrival can benefit patients with large myocardial infarctions and ST-segment elevation myocardial infarction (STEMI).
  • It includes data from the CompareCrush trial, focusing on 532 patients, of which 331 had a large myocardial area confirmed by prehospital ECG.
  • Results show that crushed prasugrel significantly improved postprocedural blood flow in STEMI patients with a large area at risk, suggesting it could be a safe and effective strategy for enhancing myocardial reperfusion in this high-risk group.
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Background: A chronic total coronary occlusion (CTO) is associated with ventricular arrhythmias (VA) in patients with an implantable cardioverter-defibrillator (ICD). Limited data is available on the incidence of VA in CTO patients without an ICD.

Objectives: To investigate the incidence of sustained VA in CTO patients after successful CTO revascularization and in patients with untreated CTO or failed CTO revascularization.

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  • The DynamX™ bioadaptor is a new coronary implant that unlocks its frame after 6 months, aiming to provide the benefits of drug-eluting stents while restoring vessel function.
  • A trial involving 445 patients compared the bioadaptor to a zotarolimus-eluting stent across 34 hospitals in three countries, with an imaging subset for further assessment.
  • The bioadaptor showed similar safety and success rates compared to stents at 12 months but demonstrated better effectiveness in reducing late lumen loss and improving vessel compliance.
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