11 research outputs found
Optimization of secondary prevention and risk stratification in patients with coronary heart disease
The first part of this thesis identified patients at low risk for recurrent events or death after STEMI. It was observed that asymptomatic patients with a LVEF>45% after one year can safely be referred to the GP with mortality rates after STEMI that come close to the rate in the general population.The second part focused to identify high-risk subpopulations to improve risk stratification. Despite current standards of care aimed at achieving targets for LDLc and other traditional risk factors, STEMI patients remain at high risk of new cardiovascular events. Valuable effort should therefore be made to further reduce residual cardiovascular risk by using additional more discriminating and more refined treatments targets like apoB and apoB/apoA1 ratio. Furthermore, novel biomarkers were identified to improve risk stratification and select high risk sub-populations. GDF-15, a more general marker for disease severity in STEMI patient demonstrated to have an additional prognostic value beyond identified risk factors and other cardiac biomarkers such as cTn and NT-proBNP.Lastly, the third part of this thesis showed that a dedicated pre-hospital triage protocol is an effective tool to select patients for admission at the cardiac emergency department. Overcrowding is a major public health problem and this thesis shows that the introduction of dedicated cardiac emergency departments can potentially reduce the caseload of the general emergency department. </p
Optimization of secondary prevention and risk stratification in patients with coronary heart disease
The first part of this thesis identified patients at low risk for recurrent events or death after STEMI. It was observed that asymptomatic patients with a LVEF>45% after one year can safely be referred to the GP with mortality rates after STEMI that come close to the rate in the general population.The second part focused to identify high-risk subpopulations to improve risk stratification. Despite current standards of care aimed at achieving targets for LDLc and other traditional risk factors, STEMI patients remain at high risk of new cardiovascular events. Valuable effort should therefore be made to further reduce residual cardiovascular risk by using additional more discriminating and more refined treatments targets like apoB and apoB/apoA1 ratio. Furthermore, novel biomarkers were identified to improve risk stratification and select high risk sub-populations. GDF-15, a more general marker for disease severity in STEMI patient demonstrated to have an additional prognostic value beyond identified risk factors and other cardiac biomarkers such as cTn and NT-proBNP.Lastly, the third part of this thesis showed that a dedicated pre-hospital triage protocol is an effective tool to select patients for admission at the cardiac emergency department. Overcrowding is a major public health problem and this thesis shows that the introduction of dedicated cardiac emergency departments can potentially reduce the caseload of the general emergency department. </p
Optimization of secondary prevention and risk stratification in patients with coronary heart disease
The first part of this thesis identified patients at low risk for recurrent events or death after STEMI. It was observed that asymptomatic patients with a LVEF>45% after one year can safely be referred to the GP with mortality rates after STEMI that come close to the rate in the general population.The second part focused to identify high-risk subpopulations to improve risk stratification. Despite current standards of care aimed at achieving targets for LDLc and other traditional risk factors, STEMI patients remain at high risk of new cardiovascular events. Valuable effort should therefore be made to further reduce residual cardiovascular risk by using additional more discriminating and more refined treatments targets like apoB and apoB/apoA1 ratio. Furthermore, novel biomarkers were identified to improve risk stratification and select high risk sub-populations. GDF-15, a more general marker for disease severity in STEMI patient demonstrated to have an additional prognostic value beyond identified risk factors and other cardiac biomarkers such as cTn and NT-proBNP.Lastly, the third part of this thesis showed that a dedicated pre-hospital triage protocol is an effective tool to select patients for admission at the cardiac emergency department. Overcrowding is a major public health problem and this thesis shows that the introduction of dedicated cardiac emergency departments can potentially reduce the caseload of the general emergency department. Pfizer, Servier Nederland Farma B.V, Daiichi Sankyo Nederland B.V.LUMC / Geneeskund
Plasma LDL-Cholesterol Level at Admission is Independently Associated with Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention
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Apolipoproteins A1, B, and apoB/apoA1 ratio are associated with first ST-segment elevation myocardial infarction but not with recurrent events during long-term follow-up
Clinical epidemiolog
Incorporation of bioactive glass in calcium phosphate cement: An evaluation
Item does not contain fulltextBioactive glasses (BGs) are known for their unique ability to bond to living bone. Consequently, the incorporation of BGs into calcium phosphate cement (CPC) was hypothesized to be a feasible approach to improve the biological performance of CPC. Previously, it has been demonstrated that BGs can successfully be introduced into CPC, with or without poly(d,l-lactic-co-glycolic) acid (PLGA) microparticles. Although an in vitro physicochemical study on the introduction of BG into CPC was encouraging, the biocompatibility and in vivo bone response to these formulations are still unknown. Therefore, the present study aimed to evaluate the in vivo performance of BG supplemented CPC, either pure or supplemented with PLGA microparticles, via both ectopic and orthotopic implantation models in rats. Pre-set scaffolds in four different formulations (1: CPC; 2: CPC/BG; 3: CPC/PLGA; and 4: CPC/PLGA/BG) were implanted subcutaneously and into femoral condyle defects of rats for 2 and 6 weeks. Upon ectopic implantation, incorporation of BG into CPC improved the soft tissue response by improving capsule and interface quality. Additionally, the incorporation of BG into CPC and CPC/PLGA showed 1.8- and 4.7-fold higher degradation and 2.2- and 1.3-fold higher bone formation in a femoral condyle defect in rats compared to pure CPC and CPC/PLGA, respectively. Consequently, these results highlight the potential of BG to be used as an additive to CPC to improve the biological performance for bone regeneration applications. Nevertheless, further confirmation is necessary regarding long-term in vivo studies, which also have to be performed under compromised wound-healing conditions