D Poldermans

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..The purpose of this research was to perform a feasibility study of prophylactic coronary revascularization in patients with preoperative extensive stress-induced ischemia...

..The current American College of Cardiology/American Heart Association guidelines do not recommend prophylactic coronary revascularization before noncardiac surgery in patients with stable coronary artery disease...

..Don Poldermans and Dr. P. J. Devereaux (co-principal investigator of POISE)...

..Inhibitors of the 3-hydroxy-3-methylglutaryl coenzyme A (statins) may reduce perioperative mortality through the improvement of lipid profile, but also through the stabilization of coronary plaques on the vascular wall...

..Observational data suggest that perioperative statin use is associated with improved recovery from acute kidney injury after high-risk vascular surgery and with improved long-term survival in patients undergoing such surgery...

..Niaspan, a prolonged-release nicotinic acid, was evaluated during the Niaspan-Induced HDL Elevation for Optimizing Risk Control (NEMO) study in The Netherlands...

..The purpose of this study was to assess the value of preoperative cardiac testing in intermediate-risk patients receiving beta-blocker therapy with tight heart rate (HR) control scheduled for major vascular surgery...

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..CONCLUSIONS: A combination of statin and beta-blocker use in patients with AAA-surgery is associated with a reduced incidence of perioperative mortality and nonfatal MI particularly in patients at the highest risk...

..Assessment of improvement of resting function may not be the ideal end point to evaluate successful revascularisation...

..A recent study found that perioperative beta-blocker therapy reduces complication rates in high-risk individuals...

..We compared the prognosis of vascular surgery patients with integrated cTnT-AUC values to continuous and standard 12-lead electrocardiography (ECG) changes...

..Dobutamine induced contractile reserve was higher in stunned regions than in hibernating and scarred myocardium, reflecting different severities of myocardial damage...

..To objectively assess the presence of polyvascular disease in patients with peripheral arterial disease and its relation to inflammation and clinical risk factors...

..This study shows that kidney function is a predictor of all-cause mortality and beta-blocker use is associated with a lower risk of death in kidney disease patients undergoing elective vascular surgery...

..We describe a hybrid method that combines finite element modelling and statistical methods to predict patient-specific aneurysm expansion...

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..Repeat coronary artery bypass grafting (redo-CABG) in patients with ischaemic cardiomyopathy is associated with high perioperative risk and worse long-term outcome compared with patients undergoing their first CABG...

..Chronic atrial fibrillation (AF) in a non-surgical setting is associated with cardiovascular events. However, the prognosis of transient new-onset AF during vascular surgery is unknown...

..In high-risk patients, it is strongly advised to administer beta-blockers with heart rate determined dose adjustment, while the effects of preoperative revascularization remain subject to debate...

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..The aim of this study is to investigate whether variation in mortality at hospital level reflects differences in quality of care of peripheral vascular surgery patients...

..To assess the predictive value of walking distance after an exercise test on long-term outcome in patients with normal and impaired ankle-brachial index (ABI)...

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..However, age is not included as a risk factor. The aim was to assess the value of the Lee-index in vascular surgery patients among different age categories...

..Ischaemia did not add significantly in predicting outcome...

..In conclusion, levels of ADAMTS13 and VWF are strongly associated with the risk of cardiovascular disease...

..1, 95% CI 1.3 to 3.2). CONCLUSIONS: Myocardial ischaemia during DSE is independently predictive of cardiac events among patients with previous myocardial revascularisation, after controlling for clinical data...

..38, 95% CI: 0.22-0.65, respectively). CONCLUSION: In patients with severe LVD undergoing major vascular surgery, the use of beta-blockers is associated with a reduced incidence of in-hospital and long-term postoperative mortality...

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..Unfortunately, substantial differences in risk factor management and treatment and long-term outcome have been reported between PAD and CAD patients...

..Our objective is to review the available literature addressing the prevalence and prognostic implications of perioperative myocardial damage in vascular surgery patients...

..Cardiac arrhythmias are a major cause for morbidity and mortality in patients undergoing non-cardiac vascular surgery...

..The purpose of this study was to assess the long-term value of dobutamine-atropine stress echocardiography (DSE) for prediction of late cardiac events in patients with proven or suspected coronary artery disease...

..In addition, moderate tight glucose control should currently be regarded as the safest and most efficient approach to patients undergoing major vascular surgery...

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..Careful preoperative evaluation of CAD and perioperative management with beta-blockers and statins may offer the physician a unique opportunity to improve patients' perioperative and long-term outcome...

..Therefore we compared cardiac outcome in patients at high-cardiac risk undergoing open or endovascular repair of infrarenal AAA using preoperative DSE results...

..77, p = 0.001 v fundamental imaging). CONCLUSIONS: Second harmonic imaging applied during dobutamine stress echocardiography increases the agreement with DISA-SPECT for detecting myocardial viability...

..This study shows the usefulness of a small, portable hand-held echo ultrasound device for the screening for abdominal aortic aneurysms...

..05). CONCLUSIONS: Plasma natriuretic peptide concentrations are raised in patients with left ventricular dysfunction, but in the presence of preserved myocardial contractile reserve, relatively low levels of ANP and BNP are present...

..30 (0.11-0.83). CONCLUSIONS: Bisoprolol significantly reduced long-term cardiac death and myocardial infarction in high-risk patients after successful major cardiac vascular surgery...

..CONCLUSION: The presence of substantial viability (four or more viable segments, 31% of the left ventricle) on FDG SPECT is predictive of improvement in LVEF and heart failure symptoms postoperatively...

..Cox proportional hazards regression was used to identify risk factors for mortality...

..To assess the long-term prognostic value of dobutamine stress echocardiography (DSE) for cardiac events (cardiac death, myocardial infarction, and late revascularization) in patients with atrial fibrillation (AF)...

..Surgical approaches for the treatment of both AAA and CAD, and most importantly, their influence on long-term outcome will be discussed in the fifth chapter...

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..Perioperative medical management should focus on improvements not only in the short-term but also in the long-term...

..Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD)...

..However, dobutamine stress echocardiography may be the favoured test in situations where there is valvar or left ventricular dysfunction...

..Assessment of contractile reserve has no incremental value for the early detection of cardiotoxicity. A baseline abnormal E/A ratio is an independent predictor of anthracycline cardiotoxicity...

..This study investigated whether impaired glucose regulation and elevated glycated haemoglobin (HbA(1c)) levels are associated with increased cardiac ischaemic events in vascular surgery patients...

..The aim of this study was to evaluate why not all patients with a substantial amount of viable tissue recover in function after revascularization...

..Optimal treatment may be surgery, especially when valve plasty can be performed, although randomized trials are currently lacking...

..To assess the relation between beta-blocker use, underlying cardiac risk, and 1-year outcome in vascular surgery patients, including the effect of beta-blocker withdrawal...

..CONCLUSIONS: Elevated cTnT levels are associated with an increased incidence of all-cause mortality in patients undergoing major vascular surgery...

..Perioperative statin therapy was associated with an improvement in postoperative cardiovascular outcome and a reduction in serum lipid levels and levels of inflammation markers...

..The aims of this study were to determine the beneficial effect of methionine loading on the predictive value of homocysteine testing for long-term mortality and major adverse cardiac events (MACE)...

..Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences...

..This review will focus on the additional prognostic value of dobutamine stress echocardiography for perioperative and late prognosis in patients with AAA and CAD...

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..beta-Blockers should be prescribed to all patients, and coronary revascularization should be reserved for high-risk patients who have a clearly defined need for revascularization independent of the need for major vascular surgery...

..Akinesis becoming dyskinesis (AKBD) at high-dose dobutamine stress echocardiography (DSE) has been disregarded as a marker of myocardial ischemia. However, its prognostic significance is unknown...

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..CONCLUSIONS: Statins appear to be associated with attenuation of AAA growth, irrespective of other known factors influencing aneurysm growth...

..Sustained improvement was associated with improved survival. In conclusion, DSE provides accurate risk stratification of patients with HF undergoing vascular surgery...

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..Aspirin, ACE-inhibitors, beta-blockers and statins reduce long-term mortality risk. Especially the very elderly may benefit from statin therapy...

..This study evaluated the prevalence of left-ventricular (LV) dysfunction in vascular surgery patients and pharmacological treatment, according ESC guidelines...

..A study was undertaken to investigate the association between COPD and total cancer mortality and to determine whether the use of statins, which have been associated with cancer risk in other settings, modified this relationship...

..The presence of an abnormal dobutamine stress echocardiography was the strongest predictor of cardiac events and provided incremental prognostic information to clinical and stress test data...

..This study assessed the predictive value of the Lee Risk Index for late mortality and long-term health status in patients after vascular surgery...

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..The aim of this study was to ascertain whether stress myocardial perfusion imaging can independently predict long-term mortality...

..Patients with a low QT dispersion had a substantial amount of viable myocardium, whereas patients with a high QT dispersion had predominantly nonviable scar tissue...

..5], 12.1 [95% CI, 2.9-51.5], and 9.0 [95% CI, 2.8-29.6]). CONCLUSION: Dobutamine stress (99m)Tc-tetrofosmin SPECT provides incremental prognostic information for the prediction of total mortality and cardiac events in elderly patients...

..Adverse cardiac events are common after vascular surgery. We hypothesized that perioperative statin therapy would improve postoperative outcomes...

..However, EVAR is not associated with long-term survival benefit. This study assessed the effect of perioperative asymptomatic cardiac damage after EVAR on long-term prognosis...

..Patients with severely depressed LV function and a low QT dispersion probably have a substantial amount of viable tissue. Conversely, when QT dispersion is high, the likelihood of substantial viability is reduced...

..The aim of this study was to assess the accuracy of stress 99m technetium tetrofosmin myocardial perfusion imaging for the diagnosis of in stent stenosis (ISS)...

..To assess the long-term prognostic value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) after major vascular surgery...

..The aim of this study was to determine whether myocardial ischemia on stress myocardial perfusion imaging can predict all causes of death in patients with diabetes mellitus...

..Repeated testing should be reconsidered 3 years after the initial evaluation and when a change in symptoms or clinical condition occurs...

..2 to 9.1). Peri-infarction ischemia assessed by stress technetium-99m sestamibi tomography is associated with a greater risk of cardiac death than is remote ischemia. The risk of reinfarction is not related to the location of ischemia...

..The aim of this study was to assess the incremental prognostic value of stress technetium 99m tetrofosmin imaging after myocardial revascularization...

..5, 95% confidence interval 1.3 to 3.7). In patients with suspected, but no history of CAD, fixed perfusion abnormalities were associated with a higher risk of death compared with reversible perfusion abnormalities...

..00, 95% CI 0.99 to 1.01). In conclusion, the discriminative value of NT-pro-BNP is most pronounced in patients with GFR > or =90 ml/min/1.73 m(2) and has no prognostic value in patients with GFR <30 ml/min/1.73 m(2)...

..Our findings indicate a favorable effect of atorvastatin on contractile reserve, possibly through an enhancement of flow-dependent coronary dilatation during stress...

..0001). CONCLUSION: Dobutamine stress (99m)Tc-sestamibi SPECT and dobutamine stress echocardiography provide comparable long-term prognostic information in addition to that afforded by clinical data...

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..The aim of this study was to assess the prognostic value of hs-CRP and NT-proBNP for postoperative cardiac events in noncardiac vascular surgery patients...

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..In this study, we evaluated whether anemia confounds the prognostic value of NT-proBNP for predicting cardiac events in patients undergoing vascular surgery...

..43, P < 0.05). CONCLUSIONS: DSE provides incremental data for the prediction of mortality and hard cardiac events in patients with diabetes who are unable to perform an adequate exercise stress test...

..2) in a multivariate analysis of clinical baseline variables and RWMAs. CONCLUSION: Elevated baseline levels of NT-proBNP are associated with the presence and extent of myocardial ischemia during DSE, independent of the presence of RWMAs...

..Coronary revascularization of the suspected culprit coronary lesion assessed by preoperative stress testing is not associated with improved outcome in vascular surgery patients...

..This study evaluated the effectiveness and safety of beta-blockers and statins for the prevention of perioperative cardiovascular events in intermediate-risk patients undergoing noncardiovascular surgery...