Publications by authors named "Ton A C M Heestermans"
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.
Article Synopsis
- The optimal management of patients with atrial fibrillation (AF) requiring oral anticoagulation (OAC) during percutaneous coronary intervention (PCI) is debated, with current guidelines suggesting a temporary triple therapy regimen that includes aspirin, which raises bleeding risks.
- A new study, the WOEST-3 trial, seeks to compare a 30-day dual antiplatelet therapy (DAPT) strategy that temporarily omits OAC against guideline-directed therapy post-PCI for AF patients, aiming to reduce bleeding without sacrificing efficacy.
- With a sample of 2,000 patients, the trial will evaluate the rates of major bleeding and adverse ischemic events, making it the first randomized controlled trial to explore the omission of OAC
Objective: We describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.
Methods: The POPular AGE registry is a prospective, multicentre study of patients ≥ 75 years of age presenting with NSTEMI, performed in the Netherlands. Management was at the discretion of the treating physician.
Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction: a COACT trials' post-hoc subgroup analysis.
Eur Heart J Acute Cardiovasc Care
July 2022
Article Synopsis
- 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
- 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.
Targeted Temperature Management in Out-of-Hospital Cardiac Arrest With Shockable Rhythm: A Post Hoc Analysis of the Coronary Angiography After Cardiac Arrest Trial.
Crit Care Med
February 2022
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.
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.
Clopidogrel in noncarriers of CYP2C19 loss-of-function alleles versus ticagrelor in elderly patients with acute coronary syndrome: A pre-specified sub analysis from the POPular Genetics and POPular Age trials CYP2C19 alleles in elderly patients.
Int J Cardiol
July 2021
Background: Patients with acute coronary syndrome (ACS) who are carrying CYP2C19 loss-of-function alleles derive less benefit from clopidogrel treatment. Despite this, in elderly patients, clopidogrel might be preferred over more potent P2Y inhibitors due to a lower bleeding risk. Whether CYP2C19 genotype-guided antiplatelet treatment in the elderly could be of benefit has not been studied specifically.
View Article and Find Full Text PDFSex 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.
View Article and Find Full Text PDFArticle Synopsis
- 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.
Article Synopsis
- Ischemic heart disease often leads to cardiac arrest, and this study aims to assess how immediate coronary angiography affects long-term clinical outcomes in patients resuscitated from cardiac arrest without STEMI.
- The research involves a multicenter clinical trial with 552 patients from Dutch centers, comparing immediate versus delayed angiography strategies, with follow-up after one year.
- Results indicate no significant difference in survival rates or adverse events between the immediate and delayed angiography groups, suggesting that the timing of the procedure may not impact outcomes significantly.
Article Synopsis
- * 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.