Publications by authors named "Widimsky Petr"

Background: The Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial enrolled patients with vascular disease, but excluded patients requiring oral anticoagulation.

Objective: To explore the clinical significance of a new diagnosis of atrial fibrillation (AF) during follow-up.

Methods: New AF was identified from hospitalization, study drug discontinuation and adverse event reports.

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Cardiogenic shock (CS) is a devastating and fatal complication of acute myocardial infarction (AMI). CS can affect the pharmacokinetics and pharmacodynamics of medications. The unique properties of cangrelor make it the optimal P2Y12 inhibitor for CS-AMI, in terms of both efficacy and safety.

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  • The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
  • It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
  • The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
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  • The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
  • Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
  • There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
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Background: Thrombosis is linked to neutrophil release of neutrophil extracellular traps (NETs). NETs are proposed as a mechanism of resistance to thrombolysis. This study intends to analyze the composition of thrombi retrieved after mechanical thrombectomy, estimate the age and organization of thrombi, and evaluate associations with the use of thrombolysis, antiplatelets, and heparin.

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  • The Prague-17 trial compared bleeding events in patients with atrial fibrillation (AF) treated with left atrial appendage closure (LAAC) versus nonvitamin K anticoagulants (NOAC).
  • During the study, which involved 402 high-risk AF patients over an average of 3.5 years, bleeding events were lower in the LAAC group (24 events) compared to the NOAC group (40 events).
  • The findings suggest that LAAC is associated with reduced nonprocedural major and clinically relevant nonmajor bleeding events, particularly noting gastrointestinal bleeding as the most common type in both treatment groups.
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  • Researchers developed a machine learning model to predict in-hospital death risk in Takotsubo syndrome (TTS) patients using data from over 3,400 individuals.
  • The model included 31 clinical variables and achieved strong performance results, with AUC values indicating high accuracy in identifying patients at risk of death.
  • Clustering analysis revealed six distinct patient groups with varying in-hospital death rates, demonstrating the model's ability to stratify risk profiles effectively.
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Introduction: Cardiovascular diseases (CVDs) are the leading cause of cardiovascular mortality and a major contributor to disability worldwide. The prevalence of CVDs is continuously increasing, and from 1990 to 2019, it has doubled. Global cardiovascular mortality has increased from 12.

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Background: Sex- and gender-associated differences determine the disease response to treatment.

Aim: The study aimed to explore the hypothesis that progress in the management of STE-myocardial infarction (STEMI) overcomes the worse outcome in women.

Methods And Results: We performed an analysis of three randomized trials enrolling patients treated with primary PCI more than 10 years apart.

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Background: Low dose rivaroxaban with aspirin reduced major cardiovascular events (MACE) compared to aspirin alone in patients with cardiovascular disease although effects on total events are unknown.

Methods: The COMPASS clinical trial randomized 27,395 participants with chronic coronary and/or peripheral artery disease to rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg daily.

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During the last 5-7 years, tremendous progress was achieved in the reperfusion treatment of acute ischaemic stroke during its first few hours from symptom onset. This review summarizes the latest evidence from randomized clinical trials and prospective registries with a focus on endovascular treatment using stent retrievers, aspiration catheters, thrombolytics, and (in selected patients) carotid stenting. Novel approaches in prehospital (mobile interventional stroke teams) and early hospital (direct transfer to angiography) management are described, and future perspectives ('all-in-one' laboratories with angiography and computed tomography integrated) are discussed.

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Article Synopsis
  • The COMPASS trial demonstrated that dual pathway inhibition using rivaroxaban and aspirin significantly reduced cardiovascular outcomes in patients with stable atherosclerotic vascular disease compared to aspirin alone, while rivaroxaban monotherapy did not show similar benefits.
  • This analysis aimed to explore the effectiveness of treatment combinations (dual pathway inhibition and rivaroxaban monotherapy) compared to aspirin, focusing on how well investigator-reported cardiovascular events aligned with centrally adjudicated events.
  • The study included over 27,000 participants and assessed the primary outcomes of cardiovascular death, stroke, and myocardial infarction, revealing important insights about treatment efficacy in this population.
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Aims: To describe outcomes of patients with chronic coronary artery disease (CAD) and/or peripheral artery disease (PAD) enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) randomized trial who were treated with the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily during long-term open-label extension (LTOLE).

Methods And Results: Of the 27 395 patients enrolled in COMPASS, 12 964 (mean age at baseline 67.

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Time is brain! This paradigm is forcing the development of strategies with potential to shorten the time from symptom onset to recanalization. One of these strategies is to transport select patients with acute ischaemic stroke directly to an angio-suite equipped with flat-detector computed tomography (FD-CT) to exclude intracranial haemorrhage, followed directly by invasive angiography and mechanical thrombectomy if large-vessel occlusion (LVO) is confirmed. To present existing published data about the direct transfer (DT) of stroke patients to angio-suites and to describe our initial experience with this stroke pathway.

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Managing patients with acute coronary syndrome (ACS) in an ageing population with comorbidities is clinically and economically challenging. Well-conducted unselected registries are essential for providing information on real-day clinical practice. The aim was to create a long term, very detail-controlled registry of unselected patients admitted with ACS to a high-volume centre in Central Europe.

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The recanalization effect of large-vessel occlusion (LVO) in anterior circulation is well documented but only some patients benefit from endovascular treatment. We analysed clinical and radiological factors determining clinical outcome after successful mechanical intervention. We included 146 patients from the Prague 16 study enrolled from September 2012 to December 2020, who had initial CT/CTA examination and achieved good recanalization status after mechanical intervention (TICI 2b-3).

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Objectives: Based on previous studies with clopidogrel, the time between acute myocardial infarction (AMI) symptoms onset and primary percutaneous coronary intervention (PCI) was proven as important prognostic factor. Our aim was to assess the relationship between symptoms onset to needle time (SNT) and procedural results and the occurrence of ischemic endpoints in primary angioplasty patients treated with potent P2Y12 inhibitors.

Methods: A total of 1,131 out of 1,230 patients randomized to the Prague-18 study (prasugrel vs.

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Background: The PRAGUE-17 (Left Atrial Appendage Closure vs Novel Anticoagulation Agents in Atrial Fibrillation) trial demonstrated that left atrial appendage closure (LAAC) was noninferior to nonwarfarin direct oral anticoagulants (DOACs) for preventing major neurological, cardiovascular, or bleeding events in patients with atrial fibrillation (AF) who were at high risk.

Objectives: This study sought to assess the prespecified long-term (4-year) outcomes in PRAGUE-17.

Methods: PRAGUE-17 was a randomized noninferiority trial comparing percutaneous LAAC (Watchman or Amulet) with DOACs (95% apixaban) in patients with nonvalvular AF and with a history of cardioembolism, clinically-relevant bleeding, or both CHADS-VASc ≥3 and HASBLED ≥2.

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Introduction: The randomized PRAGUE-17 trial demonstrated noninferiority of left atrial appendage closure (LAAC) to non-vitamin K anticoagulants (NOACs) for the prevention of major cardiovascular or cerebrovascular events. However, the left atrial appendage is an important source of natriuretic peptides and plays a role in left atrial reservoir function. Changes of heart failure (HF) biomarkers after LAAC compared to NOAC has not been studied.

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Background Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS.

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