New insights in mechanism, diagnosis and treatment of myocardial infarction

This thesis aimed to present new molecular and genetic findings in the pathology and diagnosis of acute myocardial infarction. Furthermore, a special focus was granted on the current invasive treatment of myocardial infarction. Here, new aspects were investigated in relation to a) the role of IVUS in preventing late stent thrombosis, and b) differences in coronary plaque composition, as assessed with IVUS __ Virtual Histology, after drug-eluting versus bare-metal stent implantation. Finally, the influence of the stent type as well as the patient__s genetic profile were investigated in relation to the occurrence of post-stenting complications.Netherlands Heart FoundationUBL - phd migration 201

Pathophysiology and treatment of atherosclerosis Current view and future perspective on lipoprotein modification treatment

Cardiolog

Late stent malapposition: innocent phenomenon or major risk marker?

Vascular Biology and Interventio

Clinical performance of drug-eluting stents with biodegradable polymeric coating: a meta-analysis and systematic review

Aims: Different biodegradable-polymer drug-eluting stents have not yet been systematically analysed. We sought to; 1) evaluate the risk of target lesion revascularisation (TLR) and definite stent thrombosis (DST) among different groups of biodegradable-polymer (BioPol) DES, and 2) to compare them with permanent polymer (PermPol) DES. Methods and results: We searched PubMed and relevant sources from January 2005 until October 2010. Inclusion criteria were (a) Implantation of a drug-eluting stent with biodegradable polymer; (b) available follow-up data for at least one of the clinical end-points (TLR/DST) at short term (30 days) and/or mid-term (one year). A total of 22 studies, including randomised and observational studies, with 8264 patients met the selection criteria; nine studies (2042 patients) in whom biodegradable-polymer sirolimus eluting stents (BioPol-SES) were implanted, eight studies (1731 patients) in whom biodegradable-polymer paclitaxel eluting stents (BioPol-PES) were implanted, and seven studies (4491 patients) in whom biodegradable-polymer biolimus-A9 eluting stents (BioPol-BES) were implanted. At 30 days, there was a higher risk of DST (p=0.04) and subsequently TLR (p=0.006) in the BioPol-BES compared to BioPol-SES, with no significant difference in the other stent comparisons. At 1-year, there was higher risk of TLR in the BioPol-PES (p= 0.01), and the BioPol-SES (p=0.04) compared to BioPol-BES. One-year stent thrombosis was not statistically different between the studied groups (overall p= 0.2). In another analysis comprising seven randomised trials comparing BioPol-DES (3778 patients) and PermPol-DES (3291 patients), the risks of TLR and stent thrombosis at 1-year were not significantly different (p= 0.5 for both). Conclusions: Performance of different BioPol-DES seems to vary from each other. The short- and mid-term success rates may not be superimposable. Furthermore, they may not be necessarily better than PermPol-DES

Clinical outcomes of biodegradable-polymer drug eluting stents, a meta-analysis and systematic review of randomized and observational studies

Vascular Surger

Effect of increasing doses of rosuvastatin and atorvastatin on apolipoproteins, enzymes involved in lipoprotein metabolism and inflammatory parameters

Cardiolog

Genetically determined response to inflammatory stimuli as a predictor of coronary artery disease extent and severity, in acute myocardial infarction patients

Clinical epidemiolog